Individual provider Active NPI

Lee Ann Condron, RN, ACNP

  • Nurse Practitioner
  • Livingston, TX
National Provider Identifier
1962488643
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP112378 Issued in TX
Practice address
1717 Hwy 59 S Bypass
Livingston, TX 77351
Phone
(936) 329-8326
Fax
(936) 329-8332
NPI assigned
Dec 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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 AP112378 TX Primary
Acute Care Nurse Practitioner 363LA2100X 533514 TX

Addresses

Primary practice location

1717 Hwy 59 S Bypass
Livingston, TX 77351

Mailing address

1704 Cimmarron St
Lufkin, TX 75904-4634
Phone (936) 414-2404

Other identifiers 2

IdentifierTypeStateIssuer
174262901MedicaidTX
8N8592OtherTXBLUECROSS AND BLUESHIELD OF TEXAS

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
I20040805001176 TX Practitioner - Nurse Practitioner 2860463387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

1717 Hwy 59 Loop N
Memorial Medical Livingston
Livingston, TX 77351-5703
Phone (936) 329-8700

Hospital & facility affiliations

  • CHI St Lukes Health Memorial Livingston Hospital, Livingston, TX, CCN 450395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
533514TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Nurse Practitioner CurrentSince Jul 1, 2015 Accepting new patients

Locations

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1717 Highway 59 Loop N
Livingston, TX 77352
Phone (936) 329-8500

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1962488643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 CIMMARRON ST",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759044634",
            "telephone_number": "936-414-2404",
            "fax_number": "936-329-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 HWY 59 S BYPASS",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "77351",
            "telephone_number": "936-329-8326",
            "fax_number": "936-329-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDRON",
        "first_name": "LEE",
        "middle_name": "ANN",
        "credential": "RN, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP112378",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "533514",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174262901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD OF TEXAS",
            "identifier": "8N8592",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

Verify at the official NPI Registry.