Individual provider Active NPI

Jacquelyn Michele Lagrone, MD

  • Child & Adolescent Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1801189162
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
P9625 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-8589
Phone
(214) 456-1383
NPI assigned
May 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X P9625 TX
Child & Adolescent Psychiatry Physician 2084P0804X P9625 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-8589

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-8589
Phone (214) 456-1383

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180108001799 TX Practitioner - Psychiatry 1951604891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Baylor College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluebonnet Trails Community MHMR CenterGroup PAC ID 5799775409, 59 clinicians

Practice addresses (Care Compare)

1009 N Georgetown St
Round Rock, TX 78664-3289
Phone (512) 255-1720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P9625TXMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bluebonnet Trails Community MHMR Center Psychiatry CurrentSince Jan 3, 2025 Accepting new patients
Tri-County Clinical Current Accepting new patients
Bluebonnet Trails Community MHMR Center CurrentSince Jan 3, 2025 Accepting new patients

Locations

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

1009 N Georgetown St
Round Rock, TX 78664
Phone (512) 244-8374

Interoperability endpoints

  • Direct secure messaging: jacquelyn.lagrone.1@16041.direct.athenahealth.com
  • Direct secure messaging: jacquelyn.lagrone.1@8363.direct.athenahealth.com

Organizations & group practices 3

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1801189162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908589",
            "telephone_number": "214-456-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908589",
            "telephone_number": "214-456-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGRONE",
        "first_name": "JACQUELYN",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "P9625",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "P9625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.