Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lydia Helen Nefedov, MSN, AGNP-BC

Individual provider Gerontology Nurse Practitioner · NPI 1902349772

Lydia Helen Nefedov, MSN, AGNP-BC is a Nurse Practitioner in San Antonio, Texas. Qualified in 2021, 5 years ago. Practices with Ascension Medical Group-Fox Valley Wisconsin, Inc, a 260-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana, Nevada, Ohio and Texas.

Years since qualifying
5
Licensed in
IN, NV, OH, TX
In the registry since
2016
Specialties on file
4
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.

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Practice location Address checks out

3463 Magic Dr Ste T21
San Antonio, TX 78229-3621
Phone: (210) 614-8101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3533 Southern Blvd Ste 5650, Kettering, OH 45429-1263 — (937) 294-3611

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence APRN.CNP.0040200 (OH)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence APRN002369 (NV)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 1075580 (TX)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 71013911A (IN)

Record details

NPI number1902349772
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSN , AGNP-BC
Sole proprietorNo
NPI enumeratedNovember 28, 2016
Last updated in NPPESMarch 11, 2026
Certification dateMarch 11, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ascension Medical Group-Fox Valley Wisconsin, Inc — 260 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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