Organization Active NPI

Triple Crown Care

Doing business as Healing Hands Medical Clinic

  • Family Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1750057469
Registry record updated Aug 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TRIPLE CROWN CARE
Doing business as
Healing Hands Medical Clinic
Practice address
3600 Gus Thomasson Rd Ste 117a
Mesquite, TX 75150-6729
Phone
(972) 433-0604
Fax
(972) 360-0780
NPI assigned
Aug 22, 2021
Last updated
Aug 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2021

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

Authorized official

Name
Lillian M Oandah, ADMINISTRATOR, OWNERNPI 1144642638
Title
Administrator, Owner
Phone
(972) 433-0604

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 Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3600 Gus Thomasson Rd Ste 117a
Mesquite, TX 75150-6729

Mailing address

3600 Gus Thomasson Rd Ste 117a
Mesquite, TX 75150-6729
Phone (972) 433-0604

Other names 1

  • Healing Hands Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220531002665 TX Part B Supplier - Clinic/Group Practice 8325426562 Receives reassigned benefits from 1 practitioner
Practice locations: Mesquite, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2235834Healing Hands Medical Clinic3600 Gus Thomasson Rd Suite 117a, Mesquite, TX 75150Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory

Locations

3600 Gus Thomasson Rd
Ste 117
Mesquite, TX 75150
Phone (612) 201-5149

3600 Gus Thomasson Rd
Ste 117A
Mesquite, TX 75150
Phone (972) 433-0604

Practitioners & affiliated clinicians

Practitioners 1

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": "1629590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630195200000",
    "number": "1750057469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GUS THOMASSON RD STE 117A",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506729",
            "telephone_number": "972-433-0604",
            "fax_number": "972-360-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GUS THOMASSON RD STE 117A",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506729",
            "telephone_number": "972-433-0604",
            "fax_number": "972-360-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPLE CROWN CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-22",
        "last_updated": "2021-08-29",
        "certification_date": "2021-08-29",
        "status": "A",
        "authorized_official_last_name": "OANDAH",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR, OWNER",
        "authorized_official_telephone_number": "972-433-0604",
        "authorized_official_credential": "ADMINISTRATOR, OWNER"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healing Hands Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healing Hands Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.