Individual provider Active NPI

Rachel Lee Self, FNP-C

  • Family Nurse Practitioner
  • Carrollton, TX
National Provider Identifier
1235395732
Registry record updated Dec 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
640626 Issued in TX
Practice address
2133 Greenview Dr
Carrollton, TX 75010-4108
Phone
(469) 305-8057
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 640626 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 640626 TX
Family Nurse Practitioner 363LF0000X 640626 TX Primary

Addresses

Primary practice location

2133 Greenview Dr
Carrollton, TX 75010-4108

Mailing address

2133 Greenview Dr
Carrollton, TX 75010-4108
Phone (469) 305-8057

Other identifiers 4

IdentifierTypeStateIssuer
211222901MedicaidTX
P00860920OtherTXRAILROAD
211222902MedicaidTX
818N21OtherTXBCBS

Other names 1

  • Rachel Lee Wilson 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
I20100517000450 TX Practitioner - Nurse Practitioner 0749318467 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.63 of 100Reported as group
Quality
81.05
Improvement activities
40
Cost
70.69

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cleburne Family Medicine Associates, PLLC CurrentSince Oct 16, 2022 Accepting new patients
Cfma Denton PLLC CurrentSince Jan 5, 2023 Accepting new patients
Total MD Physicians Group, PLLC CurrentSince Sep 6, 2022 Accepting new patients
T Uselton Inc Past Accepting new patients

Locations

8300 N Lamar Blvd
Ste 200A
Austin, TX 78753
Phone (512) 575-9555

3105 Colorado Blvd
Denton, TX 76210
Phone (940) 383-3444

209 Saint Louis Ave
Fort Worth, TX 76104
Phone (713) 907-6507

9591 Sage Meadow Trl
Fort Worth, TX 76177
Phone (817) 857-6534

234 W Campbell Rd
Richardson, TX 75080
Phone (972) 474-3221

2175 E Southlake Blvd
Ste 120
Southlake, TX 76092
Phone (817) 813-2700

251 E Southlake Blvd
Southlake, TX 76092
Phone (817) 424-0971

Organizations & group practices 4

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670112000000",
    "number": "1235395732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 GREENVIEW DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104108",
            "telephone_number": "469-305-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 GREENVIEW DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104108",
            "telephone_number": "469-305-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "RACHEL",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2022-12-04",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "640626",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "640626",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "640626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211222901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00860920",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211222902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "818N21",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "WILSON",
            "middle_name": "LEE",
            "credential": "APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.