Active NPI
Rebecca Leigh Lander, PA-C
- Physician Assistant
- Southlake, TX
National Provider Identifier
1609340496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1011032
- Practice address
- 1170 N Carroll Ave.
Southlake, TX 76092 - Phone
- (817) 329-6263
- Fax
- (817) 488-2410
- NPI assigned
- Jan 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1011032 | TX | Primary |
Addresses
Primary practice location
1170 N Carroll Ave.
Southlake, TX 76092
Mailing address
1170 N Carroll Ave.
Southlake, TX 76092
Phone (817) 329-6263
Other names 1
- Rebecca Propst
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2019 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1011032 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1609340496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 N CARROLL AVE.",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "76092",
"telephone_number": "817-329-6263",
"fax_number": "817-488-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 N CARROLL AVE.",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "76092",
"telephone_number": "817-329-6263",
"fax_number": "817-488-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDER",
"first_name": "REBECCA",
"middle_name": "LEIGH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "1011032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "REBECCA",
"last_name": "PROPST",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.