Organization Active NPI

Mindcare Alliance Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1124817606
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDCARE ALLIANCE HEALTH PLLC
Practice address
11615 Forest Central Dr Ste 106
Dallas, TX 75243-3829
Phone
(214) 444-9827
NPI assigned
May 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Authorized official

Name
Olumide Remi-Johnson, NURSE PRACTITIONERNPI 1346920477
Title
Director
Phone
(214) 444-9827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

11615 Forest Central Dr Ste 106
Dallas, TX 75243-3829

Mailing address

11615 Forest Central Dr Ste 106
Dallas, TX 75243-3829
Phone (214) 444-9827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251210004181 TX Part B Supplier - Clinic/Group Practice 8729572391 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

11615 Forest Central Dr
Ste 106
Dallas, TX 75243
Phone (214) 444-9827

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1124817606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11615 FOREST CENTRAL DR STE 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433829",
            "telephone_number": "214-444-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11615 FOREST CENTRAL DR STE 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433829",
            "telephone_number": "214-444-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDCARE ALLIANCE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "REMI-JOHNSON",
        "authorized_official_first_name": "OLUMIDE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-444-9827",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.