Individual provider Active NPI

Mylisa Mueller

  • Family Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1174974240
Registry record updated Apr 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP131297 Issued in TX
Practice address
1021 Matlock Rd
Mansfield, TX 76063-3443
Phone
(817) 225-6888
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP131297 TX Primary

Addresses

Primary practice location

1021 Matlock Rd
Mansfield, TX 76063-3443

Mailing address

3921 W Green Oaks Blvd
D
Arlington, TX 76016-2764
Phone (817) 496-1919

Other practice location 1

3921 W Green Oaks Blvd
D
Arlington, TX 76016-2764
Phone (817) 496-1919

Other practice location 2

1811 Highway 287 N Ste 150
Mansfield, TX 76063-7595
Phone (817) 473-3979

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
I20170214002545 TX Practitioner - Nurse Practitioner 2567745789 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP131297TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Family Medical PLLC Family CurrentSince Aug 26, 2024 Accepting new patients
Clinical Practice Support Services CurrentSince Jul 18, 2018 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2026 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2026 Accepting new patients
Katherine Johnson Wellness PLLC Family CurrentSince Feb 23, 2025 Accepting new patients
James E. Race MD PA CurrentSince Aug 1, 2025 Accepting new patients

Locations

2909 S Hampton Rd
#D107
Dallas, TX 75224
Phone (214) 467-3832

12530 Lebanon Rd
Ste 202
Frisco, TX 75035
Phone (469) 656-4602

1325 Pennsylvania Ave
Ste 560
Ft Worth, TX 76104
Phone (817) 250-7240

2900 Denton Hwy
Ste A
Haltom City, TX 76117
Phone (817) 420-6009

1811 Highway 287 N
Ste 150
Mansfield, TX 76063
Phone (817) 473-3979

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15811/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mylisa.mueller.1@15811.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524960000000",
    "number": "1174974240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 W GREEN OAKS BLVD",
            "address_2": "D",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760162764",
            "telephone_number": "817-496-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633443",
            "telephone_number": "817-225-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3921 W Green Oaks Blvd",
            "address_2": "D",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760162764",
            "country_code": "US",
            "telephone_number": "817-496-1919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1811 Highway 287 N Ste 150",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760637595",
            "country_code": "US",
            "telephone_number": "817-473-3979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "MYLISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2018-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.