Jennifer Licon, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP1071121 Issued in TX

Practice address

2701 S Georgia St
Amarillo, TX 79109-1979

Phone

(806) 350-3000

NPI assigned

Apr 19, 2022

Last updated

Apr 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FMC Medical Foundation, Inc.Group PAC ID 9133341795, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bsa Compassion Home Care Home health agency, Amarillo, TX, CCN 677943
• Bsa Hospital Hospital, Amarillo, TX, CCN 450231

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.licon.1@33715.direct.athenahealth.com

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

• FMC Medical Foundation, Inc.

  • Family Medicine Physician
  • Amarillo, TX
  • NPI 1104255272
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation
• Camden Bay LTD

  dba Bsa Compassion Home Care

  • Home Health Agency
  • Amarillo, TX
  • NPI 1245426527
  Care Compare affiliation

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1720721590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 LAKEVIEW DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091531",
            "telephone_number": "806-355-8900",
            "fax_number": "806-355-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 S GEORGIA ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091979",
            "telephone_number": "806-350-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICON",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP1071121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latina Lewis
• Robert Howard Lewis Jr., LPC
• Tingting Li, LPC
• Liberty County Hospital District No. 1 (Five Points Nursing and Rehabilitation)
• Stevi Nicole Lichtie, MS, CCC-SLP
• Mary P Lillico, R.D. L.D.
• Ju Hee Lim, DDS
• Melissa-Ann Elizabeth Limmer-Riola
• Lincare Inc
• Suzanne Lindmeier, PHARMD, RPH

• Family Nurse Practitioner in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.