Individual provider Active NPI

Taanadeeba Mitee, FNP-BC

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1316447204
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1086968 Issued in TX
Practice address
2909 Mitchell Blvd
Fort Worth, TX 76105-4642
Phone
(817) 625-4254
NPI assigned
Feb 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2022014262 TX
Family Nurse Practitioner 363LF0000X 1086968 TX Primary

Addresses

Primary practice location

2909 Mitchell Blvd
Fort Worth, TX 76105-4642

Mailing address

2909 Mitchell Blvd
Fort Worth, TX 76105-4642
Phone (817) 625-4254

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL @ntachc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022014262TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aoc FL, LLC PastSince Nov 17, 2019 Accepting new patients
Aoc TX, LLC Past 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": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1316447204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 MITCHELL BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761054642",
            "telephone_number": "817-625-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 MITCHELL BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761054642",
            "telephone_number": "817-625-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITEE",
        "first_name": "TAANADEEBA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "2022014262",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1086968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "@ntachc.org",
            "affiliation": "N",
            "address_1": "2909 Mitchell Blvd",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761054642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.