Individual provider Active NPI

Lawanda Crawford

  • Family Nurse Practitioner
  • Desoto, TX
National Provider Identifier
1659874741
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP136999 Issued in TX
Practice address
1110 E Pleasant Run Rd
Desoto, TX 75115-4202
Phone
(972) 230-8881
Fax
(972) 230-8810
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP136999 TX Primary

Addresses

Primary practice location

1110 E Pleasant Run Rd
Desoto, TX 75115-4202

Mailing address

1110 E Pleasant Run Rd
Desoto, TX 75115-4202
Phone (972) 230-8881

Other identifiers 1

IdentifierTypeStateIssuer
1659874741MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180830001055 TX Practitioner - Nurse Practitioner 5698025328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

526 E Pleasant Run
Wellmed at Heath Creek
Desoto, TX 75115-4002
Phone (972) 223-4420

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP136999TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Jan 22, 2024 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Jan 22, 2024 Accepting new patients
Ikechukwu Osuji, M.D PA CurrentSince Nov 26, 2018 Accepting new patients

Locations

333 N Shiloh Rd
Ste 107
Garland, TX 75042
Phone (945) 260-3205

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: lawanda.crawford@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1659874741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 E PLEASANT RUN RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154202",
            "telephone_number": "972-230-8881",
            "fax_number": "972-230-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 E PLEASANT RUN RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154202",
            "telephone_number": "972-230-8881",
            "fax_number": "972-230-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "LAWANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659874741",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.