Individual provider Active NPI

Juliet Chinyere Anyanwu

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1124896105
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1143768 Issued in TX
Practice address
213 Cabotwood TRL
Mansfield, TX 76063-8822
Phone
(469) 407-8846
NPI assigned
Dec 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1143768 TX Primary

Addresses

Primary practice location

213 Cabotwood TRL
Mansfield, TX 76063-8822

Mailing address

213 Cabotwood TRL
Mansfield, TX 76063-8822
Phone (469) 407-8846

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3330 Matlock Rd
Suite 202B
Arlington, TX 76015-2917

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brightlight Oasis Psychiatry and Counseling PLLC Psychiatric/Mental Health CurrentSince Oct 1, 2024 Accepting new patients

Locations

3330 Matlock Rd
Ste 202B
Arlington, TX 76015
Phone (503) 662-9385

Organizations & group practices 1

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": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1124896105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 CABOTWOOD TRL",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638822",
            "telephone_number": "469-407-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 CABOTWOOD TRL",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638822",
            "telephone_number": "469-407-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYANWU",
        "first_name": "JULIET",
        "middle_name": "CHINYERE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1143768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.