Individual provider Active NPI

Sally R Monahan, DNP, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Austin, TX
National Provider Identifier
1164456703
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP132123 Issued in TX
Practice address
1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3077
Phone
(512) 628-1855
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN.156480-COA1 OH
Pediatric Nurse Practitioner 363LP0200X AP132123 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3077

Mailing address

1301 Barbara Jordan Blvd Ste 200G
Austin, TX 78723-3078
Phone (512) 628-1855

Other identifiers 1

IdentifierTypeStateIssuer
366049001MedicaidTX

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
I20161121002423 TX Practitioner - Nurse Practitioner 6406878693 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.156480-COA1OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group CurrentSince Nov 8, 2020 Accepting new patients
Dell Children's Medical Group Pediatrics CurrentSince Feb 1, 2017 Accepting new patients
Dell Children's Medical Group CurrentSince Feb 1, 2017 Accepting new patients
Seton Family of Doctors PastSince Nov 8, 2020 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200G
Austin, TX 78723
Phone (512) 628-1813

1301 Barbara Jordan Blvd
Ste 308
Austin, TX 78723

6811 Austin Center Blvd
Ste 400
Austin, TX 78731
Phone (512) 494-4000

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

6101 Woodway Dr
Ste 200
Woodway, TX 76712
Phone (254) 537-6300

Interoperability endpoints

  • Direct secure messaging: sally.monahan.1@8363.direct.athenahealth.com

Organizations & group practices 4

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1164456703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200G",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAHAN",
        "first_name": "SALLY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "RN.156480-COA1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP132123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366049001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.