Organization Active NPI

Lisa M Buell, M.D., P.a.

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1669604088
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6164 Issued in TX
Legal business name
LISA M BUELL, M.D., P.A.
Practice address
6250 John Ryan Dr
Fort Worth, TX 76132-4115
Phone
(817) 346-6266
Fax
(817) 346-1639
NPI assigned
Aug 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Authorized official

Name
Dr. Lisa M Buell, M.D.NPI 1689660557
Title
President
Phone
(817) 346-6266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X J6164 TX Primary

Addresses

Primary practice location

6250 John Ryan Dr
Fort Worth, TX 76132-4115

Mailing address

6250 John Ryan Dr
Fort Worth, TX 76132-4115
Phone (817) 346-6266

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120829000185 TX Part B Supplier - Clinic/Group Practice 8426205345 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

6250 John Ryan Dr
Fort Worth, TX 76132
Phone (817) 346-9880

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1669604088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 JOHN RYAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324115",
            "telephone_number": "817-346-6266",
            "fax_number": "817-346-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 JOHN RYAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324115",
            "telephone_number": "817-346-6266",
            "fax_number": "817-346-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA M BUELL, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "BUELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-346-6266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.