Individual provider Active NPI

Mandy Wilson Glikas, DNP, FNP

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1700967437
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP112973 Issued in TX
Practice address
5202 82ND St
Lubbock, TX 79424-2823
Phone
(806) 725-7337
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201150038NP OR
Family Nurse Practitioner 363LF0000X AP112973 TX Primary

Addresses

Primary practice location

5202 82ND St
Lubbock, TX 79424-2823

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5228

Other practice location 1

19761 Beavercreek Rd
Oregon City, OR 97045-9557
Phone (503) 785-8770

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
I20040813000563 TX Practitioner - Nurse Practitioner 6406829910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

5202 82ND St
Lubbock, TX 79424-2823
Phone (806) 725-7337

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Feb 3, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Covenant Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Feb 3, 2024 Accepting new patients
Covenant Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Utmb Faculty Group Practice PastSince Jul 27, 2018 Accepting new patients
Clackamas County Past Accepting new patients
Jeffrey D Rettig DO PA Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

5202 82nd St
Lubbock, TX 79424
Phone (806) 701-5265

4000 24th St
#410
Lubbock, TX 79410
Phone (806) 743-7700

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Organizations & group practices 11

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1700967437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5228",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242823",
            "telephone_number": "806-725-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19761 Beavercreek Rd",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970459557",
            "country_code": "US",
            "telephone_number": "503-785-8770",
            "fax_number": "503-785-8543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLIKAS",
        "first_name": "MANDY",
        "middle_name": "WILSON",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201150038NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP112973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.