Active NPI
Phyllis McLemore, NP
- Pediatric Clinical Nurse Specialist
- Amarillo, TX
National Provider Identifier
1790940633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Clinical Nurse Specialist
- License
- 517550
- Practice address
- 1901 Medi Park
Ste 2051
Amarillo, TX 79106-2169 - Phone
- (806) 468-4600
- Fax
- (806) 468-4398
- NPI assigned
- Jul 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 517550 | TX | |
| Pediatric Clinical Nurse Specialist | 364SP0200X | 517550 | TX | Primary |
Addresses
Primary practice location
1901 Medi Park
Ste 2051
Amarillo, TX 79106-2169
Mailing address
1400 Wallace Blvd
Attn: Credentialing Dept
Amarillo, TX 79106-1708
Phone (806) 354-5585
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042483005 | Medicaid | TX | |
| 200322680 A | Medicaid | OK | |
| 042483006 | Medicaid | TX | |
| 05572568 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1790940633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 WALLACE BLVD",
"address_2": "ATTN: CREDENTIALING DEPT",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791061708",
"telephone_number": "806-354-5585",
"fax_number": "806-356-4673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 MEDI PARK",
"address_2": "STE 2051",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062169",
"telephone_number": "806-468-4600",
"fax_number": "806-468-4398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEMORE",
"first_name": "PHYLLIS",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-21",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "517550",
"primary": false
},
{
"code": "364SP0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Pediatrics",
"state": "TX",
"license": "517550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "042483005",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200322680 A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "042483006",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05572568",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.