Individual provider Active NPI

Lynn M Sisk, MSN, FNP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1922058486
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
442781 Issued in TX
Practice address
5701 Bryant Irvin Rd
Suite 301
Fort Worth, TX 76132-4029
Phone
(817) 361-6200
Fax
(817) 361-6201
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 442781 TX
Family Nurse Practitioner 363LF0000X 442781 TX Primary

Addresses

Primary practice location

5701 Bryant Irvin Rd
Suite 301
Fort Worth, TX 76132-4029

Mailing address

5701 Bryant Irvin Rd
Suite 301
Fort Worth, TX 76132-4029
Phone (817) 361-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsisk225260@direct.sw.org

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
I20100429000291 TX Practitioner - Nurse Practitioner 4688701378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
442781TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Jan 1, 2002 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 1, 2002 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

5701 Bryant Irvin Rd
Ste 301
Ft Worth, TX 76132
Phone (817) 346-4242

Interoperability endpoints

  • Direct secure messaging: lsisk225260@direct.sw.org

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1922058486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD",
            "address_2": "SUITE 301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324029",
            "telephone_number": "817-361-6200",
            "fax_number": "817-361-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD",
            "address_2": "SUITE 301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324029",
            "telephone_number": "817-361-6200",
            "fax_number": "817-361-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISK",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "442781",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "442781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsisk225260@direct.sw.org",
            "affiliation": "N",
            "address_1": "5701 Bryant Irvin Rd",
            "address_2": "Suite 301",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761324029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.