Individual provider Active NPI

Lizamma Varghese, FNP

  • Family Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1942764717
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139385 Issued in TX
Practice address
3601 Alexandrite Way
Round Rock, TX 78681-2438
Phone
(512) 989-2372
NPI assigned
Jan 25, 2019
Last updated
Jan 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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 AP139385 TX Primary

Addresses

Primary practice location

3601 Alexandrite Way
Round Rock, TX 78681-2438

Mailing address

3601 Alexandrite Way
Round Rock, TX 78681-2438
Phone (512) 989-2372

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP139385TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1942764717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 ALEXANDRITE WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786812438",
            "telephone_number": "512-989-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 ALEXANDRITE WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786812438",
            "telephone_number": "512-989-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "LIZAMMA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.