Individual provider Active NPI

Juliet I Wabara

  • Psychiatric/Mental Health Nurse Practitioner
  • McKinney, TX
National Provider Identifier
1215697115
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP143506 Issued in TX
Practice address
9900 Moccasin Creek LN
McKinney, TX 75071-6525
Phone
(469) 230-0504
NPI assigned
Dec 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP143506 TX Primary

Addresses

Primary practice location

9900 Moccasin Creek LN
McKinney, TX 75071-6525

Mailing address

9900 Moccasin Creek LN
McKinney, TX 75071-6525
Phone (469) 230-0504

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
I20220121000792 TX Practitioner - Nurse Practitioner 0547652687 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cji Health & Wellness PLLC Psychiatric/Mental Health CurrentSince Jun 4, 2024 Accepting new patients
Premier Independent Physicians Group, Inc. PastSince May 1, 2019 Accepting new patients

Organizations & group practices 2

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": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1215697115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 MOCCASIN CREEK LN",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716525",
            "telephone_number": "469-230-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 MOCCASIN CREEK LN",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716525",
            "telephone_number": "469-230-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WABARA",
        "first_name": "JULIET",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP143506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.