Individual provider Active NPI

Jasmine Lax, FNP-BC

  • Family Nurse Practitioner
  • Southlake, TX
National Provider Identifier
1861007221
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1018939 Issued in TX
Practice address
1050 E State Highway 114 Ste 100
Southlake, TX 76092-5254
Phone
(817) 329-8364
NPI assigned
Sep 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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 1018939 TX Primary

Addresses

Primary practice location

1050 E State Highway 114 Ste 100
Southlake, TX 76092-5254

Mailing address

1050 E State Highway 114 Ste 100
Southlake, TX 76092-5254

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
I20210524002116 TX Practitioner - Nurse Practitioner 0749689719 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1018939TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Express Clinics Network PLLC CurrentSince May 12, 2021 Accepting new patients

Locations

1212 N Josey Ln
Ste 110
Carrollton, TX 75006
Phone (469) 294-1402

209 N Bonnie Brae St
Denton, TX 76201
Phone (940) 243-0104

Interoperability endpoints

  • Direct secure messaging: jasmine.lax@vmcl.eclinicaldirectplus.com

Organizations & group practices 1

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": "1599868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1861007221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E STATE HIGHWAY 114 STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E STATE HIGHWAY 114 STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925254",
            "telephone_number": "817-329-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAX",
        "first_name": "JASMINE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-12",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1018939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.