IDA MADOKA LIGHTFOOT RN PMHNP NPI 1851397046

NPI Information

NPI: 1851397046
Provider Name: IDA MADOKA LIGHTFOOT, RN, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
6404 INTERNATIONAL PKWY STE 1010
PLANO, TX
ZIP 75093
Phone: (972) 267-1988
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Ida Madoka Lightfoot, RN, PMHNP is a psychiatric/mental health nurse practitioner in Plano, TX. Ida Madoka Lightfoot, RN, PMHNP NPI is 1851397046. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6404 INTERNATIONAL PKWY STE 1010
PLANO, TX
ZIP 75093-346
Phone: (972) 267-1988

The NPI 1851397046 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2005 and was last updated on 7/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	593409	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	368676801	MEDICAID	TEXAS
2	P94062	OTHER	TEXAS	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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