Trophy Club Family Medicine PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TROPHY CLUB FAMILY MEDICINE PA

Doing business as

Trophy Club Family Medicine

Practice address

301 Trophy Lake Dr
#136
Trophy Club, TX 76262-5238

Phone

(817) 430-9111

Fax

(817) 430-8911

NPI assigned

Sep 14, 2005

Last updated

Oct 31, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lainey Gee

Title

Business Manager

Phone

(817) 430-9111

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Trophy Club Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Charlton Diaz, DO

  • Family Medicine Physician
  • Trophy Club, TX
  • NPI 1265068118
  Medicare reassignment Care Compare group NPD
• David Chae Man Yi, MD

  • Family Medicine Physician
  • Trophy Club, TX
  • NPI 1700899044
  Medicare reassignment Care Compare group NPD
• Carol A Addy, PA

  • Physician Assistant
  • Trophy Club, TX
  • NPI 1356472559
  Medicare reassignment Care Compare group
• April Enard, DO

  • Family Medicine Physician
  • Sweetwater, TX
  • NPI 1558654087
  Medicare reassignment NPD
• Paula Annette Lansford-Seabaugh, D.O.

  • Allergy & Immunology Physician
  • Killeen, TX
  • NPI 1497919583

  Family Medicine

  Medicare reassignment NPD
• Laura Flusche, FNP

  • Family Nurse Practitioner
  • Trophy Club, TX
  • NPI 1013616374
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1922093061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TROPHY LAKE DR",
            "address_2": "#136",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625238",
            "telephone_number": "817-430-9111",
            "fax_number": "817-430-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 TROPHY LAKE DR",
            "address_2": "#136",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625238",
            "telephone_number": "817-430-9111",
            "fax_number": "817-430-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROPHY CLUB FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "GEE",
        "authorized_official_first_name": "LAINEY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "817-430-9111"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148222601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0008JQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trophy Club Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Texas Em-1 Medical Services, PA
• Texas Radiation Oncology Medical Group, PLLC
• The Powerful Body PLLC
• Shilpa Elizabeth Thomas, DPT
• Town of Trophy Club (Trophy Club EMS)
• Trophy Club Medical Center LP (Baylor Scott & White Medical Center - Trophy Club)
• Trophy Club Medical Services, LLP (Trophy Club Family Medicine)
• Trophy Club Pediatrics PA
• Trophy Club Smiles PLLC
• Trophy Club Vision Care LLP

• Family Medicine Physician in Trophy Club, TX
• Providers in Trophy Club, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.