Individual provider Active NPI

Audrey Miao, APRN

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1275330599
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1191559 Issued in TX
Practice address
3040 W Camp Wisdom Rd Ste 170
Grand Prairie, TX 75052-4640
Phone
(972) 645-5109
Fax
(512) 782-9316
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 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 1191559 TX Primary

Addresses

Primary practice location

3040 W Camp Wisdom Rd Ste 170
Grand Prairie, TX 75052-4640

Mailing address

3040 W Camp Wisdom Rd Ste 170
Grand Prairie, TX 75052-4640
Phone (972) 645-5109

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
I20250312000035 TX Practitioner - Nurse Practitioner 6204357874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Total MD Physicians Group, PLLCGroup PAC ID 7012313521, 127 clinicians

Practice addresses (Care Compare)

234 W Campbell Rd
Richardson, TX 75080-3512
Phone (972) 474-3221

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1191559TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total MD Physicians Group, PLLC CurrentSince Feb 24, 2025 Accepting new patients

Locations

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

2200 W University Dr
Ste 150
Denton, TX 76201
Phone (940) 304-0189

3040 W Camp Wisdom Rd
Ste 170
Grand Prairie, TX 75052
Phone (972) 645-5109

8528 Davis Blvd
Ste 150
North Richland Hills, TX 76182
Phone (817) 242-2630

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

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1275330599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 W CAMP WISDOM RD STE 170",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524640",
            "telephone_number": "972-645-5109",
            "fax_number": "512-782-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 W CAMP WISDOM RD STE 170",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524640",
            "telephone_number": "972-645-5109",
            "fax_number": "512-782-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIAO",
        "first_name": "AUDREY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1191559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.