Individual provider Active NPI

Lisa Ann Dubos, CNS

  • Clinical Nurse Specialist
  • Temple, TX
National Provider Identifier
1922066166
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
639004 Issued in TX
Practice address
1901 SW H K Dodgen Loop
Temple, TX 76502-1814
Phone
(254) 935-4000
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroscience Clinical Nurse Specialist 364SN0800X 639004 TX
Pediatric Clinical Nurse Specialist 364SP0200X 639004 TX
Clinical Nurse Specialist 364S00000X 639004 TX Primary

Addresses

Primary practice location

1901 SW H K Dodgen Loop
Temple, TX 76502-1814

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-8800

Other identifiers 1

IdentifierTypeStateIssuer
188220101MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ldubos205914@direct.sw.org Direct

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
I20060621000175 TX Practitioner - Certified Clinical Nurse Specialist (CNS) 9032121744 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Mar 22, 2017 Accepting new patients
Scott & White Clinic CurrentSince Mar 22, 2017 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Texas Institute of Medicine and Surgery Clinical Nurse Specialist Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

1700 University Dr E
College Station, TX 77840
Phone (979) 691-3300

1901 SW H K Dodgen Loop
Temple, TX 76502
Phone (254) 742-9256

2401 S 31st St
Bldg 35
Temple, TX 76508
Phone (254) 724-2663

Interoperability endpoints

  • Direct secure messaging: ldubos205914@direct.sw.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1922066166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SW H K DODGEN LOOP",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021814",
            "telephone_number": "254-935-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SN0800X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neuroscience",
            "state": "TX",
            "license": "639004",
            "primary": false
        },
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "TX",
            "license": "639004",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": "639004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188220101",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldubos205914@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1901 SW H K Dodgen Loop",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765021814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.