Individual provider Active NPI

Charissa Elton-Lacasse, NP-C

  • Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1891718771
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
605266 Issued in TX
Practice address
3500 I-30 Box
Mesquite, TX 78185-1672
Phone
(972) 698-3300
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 605266 TX Primary

Addresses

Primary practice location

3500 I-30 Box
Mesquite, TX 78185-1672

Mailing address

843 Yellow Tavern CT
Grand Prairie, TX 75052-1648
Phone (214) 686-8564

Other identifiers 1

IdentifierTypeStateIssuer
605266OtherTXNURSE PRACTITIONERS

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
605266TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Emergency Physicians PLLC Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Dallas Emergency Physicians PLLC Past Accepting new patients
Motley Emergency Physicians Past Accepting new patients
Texas Em-1 Medical Services PA Nurse Practitioner Past Accepting new patients

Organizations & group practices 5

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891718771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 YELLOW TAVERN CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521648",
            "telephone_number": "214-686-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 I-30 BOX",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "781851672",
            "telephone_number": "972-698-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTON-LACASSE",
        "first_name": "CHARISSA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "605266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONERS",
            "identifier": "605266",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.