Individual provider Active NPI

Lilian Efosa Davidson

  • Psychiatric/Mental Health Nurse Practitioner
  • McKinney, TX
National Provider Identifier
1578349338
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1120093 Issued in TX
Practice address
2216 Triton Dr
McKinney, TX 75071-1290
Phone
(214) 469-8328
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1120093 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1120093 TX Primary

Addresses

Primary practice location

2216 Triton Dr
McKinney, TX 75071-1290

Mailing address

2216 Triton Dr
McKinney, TX 75071-1290
Phone (121) 446-9832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ, CO3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240102002669 TX Practitioner - Nurse Practitioner 3072963149 Reassigns benefits to 1 organization
I20240429001589 AZ Practitioner - Nurse Practitioner 3072963149 Reassigns benefits to 1 organization
I20240916003860 CO Practitioner - Nurse Practitioner 3072963149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12255 University Dr
Suite 200492
Frisco, TX 75035-9446

2216 Triton Dr
McKinney, TX 75071-1290
Phone (214) 469-8328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Safestar Psychiatric and Wellness LLC Nurse Practitioner CurrentSince Nov 15, 2023 Accepting new patients
BM Global Healthcare Services LLC Psychiatric/Mental Health PastSince Aug 1, 2023 Accepting new patients

Locations

12255 University Dr
Ste 200492
Frisco, TX 75035

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1578349338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 TRITON DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750711290",
            "telephone_number": "121-446-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 TRITON DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750711290",
            "telephone_number": "214-469-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "LILIAN",
        "middle_name": "EFOSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1120093",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1120093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.