Jamie K Modrall, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

650239 Issued in TX

Practice address

18601 Lyndon B Johnson Fwy Ste 315
Mesquite, TX 75150-5612

Phone

(972) 686-1795

Fax

(972) 686-1798

NPI assigned

Jul 19, 2006

Last updated

Nov 7, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Express Clinic, LLCGroup PAC ID 7911003017, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• The Express Clinic, LLC

  dba Express Care Clinic

  • Family Nurse Practitioner
  • Lincoln, NE
  • NPI 1477759348
  Medicare reassignment Care Compare group NPD
• The Express Clinic LLC

  dba West Lincoln Family Medicine

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1235468778
  NPD
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814
  NPD (past)
• The Express Clinic, LLC

  dba Express Care Clinic

  • Clinic/Center
  • Lincoln, NE
  • NPI 1831252121
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1336169002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18601 LYNDON B JOHNSON FWY STE 315",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751505612",
            "telephone_number": "972-686-1795",
            "fax_number": "972-686-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18601 LYNDON B JOHNSON FWY STE 315",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751505612",
            "telephone_number": "972-686-1795",
            "fax_number": "972-686-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODRALL",
        "first_name": "JAMIE",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "650239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041477302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041477304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Sharmon Mitchell, LCSW
• Krista Nichole Mitchell
• MJ Home Health Agency Inc
• MJS Home Health Care, Inc. (Texas Family Choice Home Health Care)
• Modern Health & Wellness LLC
• Ghedi Abdulaziz Mohamed
• Barbara Mohrle, OT
• Momentum Counseling and Consulting PLLC
• Lilian K Monie
• Ashlin Simone Monk

• Family Nurse Practitioner in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.