Individual provider Active NPI

Meghan Lynn Liebum, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1063864239
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP134803 Issued in TX
Practice address
4480 Bryant Irvin Rd
Fort Worth, TX 76132-1064
Phone
(682) 212-9160
NPI assigned
Jul 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2295968 MA
Family Nurse Practitioner 363LF0000X AP134803 TX Primary

Addresses

Primary practice location

4480 Bryant Irvin Rd
Fort Worth, TX 76132-1064

Mailing address

5937 Donnelly Ave
Fort Worth, TX 76107-5811
Phone (281) 799-2725

Other practice location 1

55 Lake Ave N
Department of Emergency Medicine
Worcester, MA 01655-0002
Phone (508) 421-1400

Other practice location 2

5937 Donnelly Ave
Fort Worth, TX 76107-5811
Phone (281) 799-2725

Other identifiers 1

IdentifierTypeStateIssuer
110118086AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mliebum2080921@direct.texashealth.org Health Information Exchange (HIE)

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
I20180213001424 TX Practitioner - Nurse Practitioner 3375821929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Urgent CareGroup PAC ID 0345654414, 128 clinicians

Practice addresses (Care Compare)

612 E Lamar Blvd
Arlington, TX 76011-4121
Phone (866) 416-6687

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Urgent Care Family Current Accepting new patients
Texas Health Urgent Care CurrentSince Sep 1, 2022 Accepting new patients
Texas Health Urgent Care Current Accepting new patients
Integrative Emergency Services Physician Group PA CurrentSince Jan 4, 2018 Accepting new patients
Texas Health Urgent Care Current Accepting new patients

Locations

612 E Lamar Blvd
Arlington, TX 76011
Phone (682) 236-5770

6411 E Northwest Hwy
Dallas, TX 75231
Phone (469) 495-9110

5937 Donnelly Ave
Fort Worth, TX 76107
Phone (469) 495-9142

4480 Bryant Irvin Rd
Fort Worth, TX 76132
Phone (361) 222-9020

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

125 Davis Blvd
Southlake, TX 76092
Phone (682) 212-9104

Interoperability endpoints

  • Direct secure messaging: mliebum2080921@direct.texashealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1063864239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5937 DONNELLY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075811",
            "telephone_number": "281-799-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 BRYANT IRVIN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321064",
            "telephone_number": "682-212-9160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_2": "Department of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5937 Donnelly Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761075811",
            "country_code": "US",
            "telephone_number": "281-799-2725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBUM",
        "first_name": "MEGHAN",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2295968",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110118086A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mliebum2080921@direct.texashealth.org",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange (HIE)",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5937 Donnelly Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761075811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.