Individual provider Active NPI

Koi-Lucie Abbott, FNP

  • Family Nurse Practitioner
  • Bedford, TX
National Provider Identifier
1821740309
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1067814 Issued in TX
Practice address
2516 Woodfield Way
Bedford, TX 76021-2617
Phone
(316) 519-9372
NPI assigned
Jan 25, 2022
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1067814 TX Primary

Addresses

Primary practice location

2516 Woodfield Way
Bedford, TX 76021-2617

Mailing address

2516 Woodfield Way
Bedford, TX 76021-2617
Phone (316) 519-9372

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220908001090 TX Practitioner - Nurse Practitioner 0648654764 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1067814TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dal Post Acute Partners, PLLC Family CurrentSince Nov 15, 2023 Accepting new patients
Optima Afya Clinic LLC Family CurrentSince Nov 1, 2025 Accepting new patients
Vpa of Texas PLLC CurrentSince Jun 1, 2024 Accepting new patients
Vpa of Texas PLLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

1143 Rockingham Dr
Ste 107
Richardson, TX 75080
Phone (214) 987-2100

1143 Rockingham Dr
Ste 107A
Richardson, TX 75080
Phone (972) 559-4150

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1821740309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 WOODFIELD WAY",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760212617",
            "telephone_number": "316-519-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 WOODFIELD WAY",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760212617",
            "telephone_number": "316-519-9372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "KOI-LUCIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1067814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.