Lighthouse Health Clinic

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

629991 Issued in TX

Legal business name

LIGHTHOUSE HEALTH CLINIC

Practice address

601 E Whitestone Blvd
Suite 308
Cedar Park, TX 78613-9015

Phone

(512) 528-9996

Fax

(512) 528-9070

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Linda S. Donovan, CPNPNPI 1508986514

Title

Pediatric Nurse Practitioner

Phone

(512) 528-9996

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Lighthouse Pediatrics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Linda Susan Donovan, CPNP, FNPC

  • Pediatric Nurse Practitioner
  • Cedar Park, TX
  • NPI 1508986514

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1780710319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E WHITESTONE BLVD",
            "address_2": "SUITE 308",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786139015",
            "telephone_number": "512-528-9996",
            "fax_number": "512-528-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E WHITESTONE BLVD",
            "address_2": "SUITE 308",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786139015",
            "telephone_number": "512-528-9996",
            "fax_number": "512-528-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "DONOVAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PEDIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "512-528-9996",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPNP"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "629991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION PN",
            "identifier": "98261",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTIVE AUTHORITY #",
            "identifier": "02468",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "629991",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Nurse Practitioner in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.