Mona Lisa Jimenez, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP146065 Issued in TX

Practice address

431 E State Highway 114 FL 1
Southlake, TX 76092-4412

Phone

(844) 824-8775

NPI assigned

Jul 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Progressive Behavioral Health, PLLC 366 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.monajimenez@136732.advancedmd-direct.com

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.

• Progressive Behavioral Health, PLLC

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238

  Psychiatric/Mental Health, TX

  Medicare reassignment Care Compare group NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  NPD (past)

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1043828544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 GREENWAY DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382447",
            "telephone_number": "817-751-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E STATE HIGHWAY 114 FL 1",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924412",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Greenway Dr",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750382447",
            "country_code": "US",
            "telephone_number": "817-751-7802",
            "fax_number": "817-751-7802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MONA",
        "middle_name": "LISA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP146065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myka Jenson, RBT
• Jerry W Morris PA
• Jet Dental of Texas, PLLC
• Dorian Louis Jimenez, D.P.M.
• Emily M Jimenez, PHD, LP, NCSP, MED
• Jeanne Marsh Joglar, MD
• John Ryan Price, D.C., P.a.
• Abigail Grace John, APRN, FNP-BC, NP-C
• Barbara S Johnson, PMHNP
• Bryan Johnson, RD

• All providers in Southlake, TX
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.