Individual provider Active NPI

Amy Christine Tackel, NP

  • Family Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1194260828
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132929 Issued in TX
Practice address
1011 Matlock Rd
Mansfield, TX 76063-3443
Phone
(817) 225-6888
Fax
(817) 377-6570
NPI assigned
Jan 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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 AP132929 TX Primary

Addresses

Primary practice location

1011 Matlock Rd
Mansfield, TX 76063-3443

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Other names 1

  • Mr. Amy Arnold Allemand Former name

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
I20170404001407 TX Practitioner - Nurse Practitioner 3476839515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
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)

1021 Matlock Rd
Suite 101
Mansfield, TX 76063-3443
Phone (817) 225-6888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132929TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. CurrentSince Mar 13, 2017 Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Mar 13, 2017 Accepting new patients
Texas Health Care, P.L.L.C. Current Accepting new patients

Locations

1021 Matlock Rd
Ste 101
Mansfield, TX 76063
Phone (817) 225-6888

1011 Matlock Rd
Mansfield, TX 76063
Phone (817) 225-6888

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

Interoperability endpoints

  • Direct secure messaging: amy.allemand.1@23969.direct.athenahealth.com
  • Direct secure messaging: amy.allemand.p1@direct.thc.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1194260828",
    "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": "817-377-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633443",
            "telephone_number": "817-225-6888",
            "fax_number": "817-377-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKEL",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-04",
        "last_updated": "2023-11-15",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ALLEMAND",
            "middle_name": "ARNOLD",
            "prefix": "MR.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.