Individual provider Active NPI

Amy Renee Lewis, R.N., AGPCNP-BC

  • Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1164793246
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP121311 Issued in TX
Practice address
2800 E Broad St Ste 517
Mansfield, TX 76063-6417
Phone
(817) 592-3360
Fax
(817) 549-5151
NPI assigned
Jan 20, 2012
Last updated
Jul 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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 AP121311 TX Primary
Adult Health Nurse Practitioner 363LA2200X AP121311 TX

Addresses

Primary practice location

2800 E Broad St Ste 517
Mansfield, TX 76063-6417

Mailing address

2800 E Broad St Ste 517
Mansfield, TX 76063-6417
Phone (817) 592-3360

Other identifiers 3

IdentifierTypeStateIssuer
6R7554OtherTXGROUP MEDICARE PTAN
V0190197OtherTXTEXAS DEPARTMENT OF PUBLIC SAFETY (DPS) CONTROLLED SUBSTANCES REG.
BCBSOtherTX8XC231

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
I20120808000989 TX Practitioner - Nurse Practitioner 3870749781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mansfield Neurology Associates PLLCGroup PAC ID 8022551357, 2 clinicians

Practice addresses (Care Compare)

2800 E Broad St
Suite 517
Mansfield, TX 76063-6417
Phone (817) 688-4451

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP121311TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mansfield Neurology Associates PLLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

2800 E Broad St
Ste 517
Mansfield, TX 76063
Phone (817) 592-3360

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1164793246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST STE 517",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636417",
            "telephone_number": "817-592-3360",
            "fax_number": "817-549-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST STE 517",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636417",
            "telephone_number": "817-592-3360",
            "fax_number": "817-549-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AMY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "R.N., AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP121311",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP121311",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "6R7554",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF PUBLIC SAFETY (DPS) CONTROLLED SUBSTANCES REG.",
            "identifier": "V0190197",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "8XC231",
            "identifier": "BCBS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.