Individual provider Active NPI

Lori Ann Vicsek, FNP

  • Family Nurse Practitioner
  • Corsicana, TX
National Provider Identifier
1982904876
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP119664 Issued in TX
Practice address
618 N Main St
Corsicana, TX 75110-3028
Phone
(903) 872-2151
Fax
(903) 872-0126
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 773080 TX
Family Nurse Practitioner 363LF0000X AP119664 TX Primary

Addresses

Primary practice location

618 N Main St
Corsicana, TX 75110-3028

Mailing address

618 N Main St
Corsicana, TX 75110-3028
Phone (903) 872-2151

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
I20161227000933 TX Practitioner - Nurse Practitioner 0042439028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Navarro County Ambulatory Care AssociationGroup PAC ID 2466827035, 2 clinicians

Practice addresses (Care Compare)

618 N Main St
Corsicana, TX 75110-3028
Phone (903) 874-6731

Hospital & facility affiliations

  • Navarro Regional Hospital Hospital, Corsicana, TX, CCN 450447

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
773080TXMDFamily Nurse Practitioner
AP119664TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Navarro County Ambulatory Care Association CurrentSince Aug 7, 2024 Accepting new patients
Corsicana-Navarro County Public Health District CurrentSince Aug 7, 2024 Accepting new patients

Locations

618 N Main St
Corsicana, TX 75110
Phone (903) 874-6711

Interoperability endpoints

  • Direct secure messaging: lori.vicsek.1@29197.direct.athenahealth.com

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.

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": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1982904876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N MAIN ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103028",
            "telephone_number": "903-872-2151",
            "fax_number": "903-872-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N MAIN ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103028",
            "telephone_number": "903-872-2151",
            "fax_number": "903-872-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICSEK",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "773080",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP119664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.