Kimberly Phillips Mizener, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP122836 Issued in TX

Practice address

1622 8TH Ave Ste 110
Fort Worth, TX 76104-4155

Phone

(817) 920-0924

Fax

(817) 921-3708

NPI assigned

Jan 4, 2013

Last updated

Feb 19, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.mizener.p1@direct.thc.nextgenshare.com

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.

• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment Care Compare group NPD
• Innovative Infusions, LLC

  dba Paragon Infusion Centers

  • Infusion Therapy Clinic/Center
  • Dallas, TX
  • NPI 1811299944

  Nurse Practitioner

  Medicare reassignment NPD
• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Urology Physician
  • Dallas, TX
  • NPI 1700831484
  NPD
• Innovative Infusions, LLC

  dba Paragon Infusion Centers

  • Infusion Therapy Clinic/Center
  • Indianapolis, IN
  • NPI 1093512246

  Nurse Practitioner

  NPD
• Texas Health Care, P.L.L.C.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1124185814
  NPD (past)

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1174860597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-921-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 8TH AVE STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044155",
            "telephone_number": "817-920-0924",
            "fax_number": "817-921-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZENER",
        "first_name": "KIMBERLY",
        "middle_name": "PHILLIPS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP122836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Anthony Mittelbronn, MD
• Samuel Mitton
• Salma Mitwan
• David William Mize
• Terry Mizell, LPC
• Adin William Mizer, MD
• MJB Medical Supplies, LLC
• Mjheath Enterprises (Expert Mobility)
• MLD Healthcare, LLC (MD Your-ology Health)
• Agnieszka E Mlodnicka, PHD

• Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.