Individual provider Active NPI

Mavis Ameyaa, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1245632405
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0039258 Issued in OH
Practice address
821 E SE Loop 323 Ste 360
Tyler, TX 75701-9667
Phone
(614) 556-0452
NPI assigned
Sep 18, 2014
Last updated
May 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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 APRN.CNP.0039258 OH Primary

Addresses

Primary practice location

821 E SE Loop 323 Ste 360
Tyler, TX 75701-9667

Mailing address

821 E SE Loop 323 Ste 360
Tyler, TX 75701-9667
Phone (614) 556-0452

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
I20260218002871 TX Practitioner - Nurse Practitioner 8224518188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

424 Church St
Nashville, TN 37219-2301

801 Mellow LN
Anna, TX 75409-1356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0039258OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physician Services of Texas, P.a. CurrentSince Feb 1, 2026 Accepting new patients

Locations

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Organizations & group practices 1

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1245632405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E SE LOOP 323 STE 360",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019667",
            "telephone_number": "614-556-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E SE LOOP 323 STE 360",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019667",
            "telephone_number": "614-556-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMEYAA",
        "first_name": "MAVIS",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2025-05-13",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0039258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.