Mary Patricia Headley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22257 Issued in CA

Practice address

5838 Edison PL
Ste 100
Carlsbad, CA 92008-5520

Phone

(214) 460-3036

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memory Check Psychological Services, a Professional CorporationGroup PAC ID 7416856422, 78 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Memory Check Psychological Services, a Professional Corporation

  • Clinical Psychologist
  • Carlsbad, CA
  • NPI 1912184219

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Medcare House Calls LLC

  • Nurse Practitioner
  • Dallas, TX
  • NPI 1265694343
  NPD (past)
• Medistat Group Associates, Inc.

  • Adult Medicine Physician
  • Desoto, TX
  • NPI 1376565341
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1114006665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 EDISON PL",
            "address_2": "STE 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920085520",
            "telephone_number": "214-460-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 EDISON PL",
            "address_2": "STE 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920085520",
            "telephone_number": "214-460-3036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 McKinnon St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752011044",
            "country_code": "US",
            "telephone_number": "214-754-8700 x335",
            "fax_number": "469-893-1938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "508116",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "22257",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paris Hayes
• Bradon Haynes
• Amanda Hazen
• Head to Toe Laser Centers
• Head to Toe Laser Centers PC (Wellness Etcetera)
• Healthworx Inc.
• Healthy Aging Centers (GameDay Men's Health)
• Hearing Experience, LLC
• Hearinglife Hearing Aid Center LLC
• Heart Centered Marriage and Family Therapy Inc.

• Family Nurse Practitioner in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.