Active NPI
Pie Bimenyimana, PMHNP
- Psychiatry Physician
- Fort Worth, TX
National Provider Identifier
1063279222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1127645
- Practice address
- 5712 Sleepy Creek LN
Fort Worth, TX 76179-7616 - Phone
- (817) 770-6612
- NPI assigned
- Mar 4, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1127645 | TX | Primary |
Addresses
Primary practice location
5712 Sleepy Creek LN
Fort Worth, TX 76179-7616
Mailing address
5712 Sleepy Creek LN
Fort Worth, TX 76179-7616
Phone (817) 770-6612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1127645 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1063279222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5712 SLEEPY CREEK LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761797616",
"telephone_number": "817-770-6612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5712 SLEEPY CREEK LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761797616",
"telephone_number": "817-770-6612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIMENYIMANA",
"first_name": "PIE",
"credential": "PMHNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-04",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "1127645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.