Individual provider Active NPI

Heidi M Mansy, NP

  • Nurse Practitioner
  • Lake Jackson, TX
National Provider Identifier
1396009015
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
654373 Issued in TX
Practice address
100 Medical Dr
Lake Jackson, TX 77566-5674
Phone
(979) 297-4411
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 654373 TX Primary

Addresses

Primary practice location

100 Medical Dr
Lake Jackson, TX 77566-5674

Mailing address

1717 Main St
Ste 5200
Dallas, TX 75201-4612
Phone (214) 712-2000

Other identifiers 3

IdentifierTypeStateIssuer
881N41OtherTXBCBS
1396009015OtherTXTRICARE
305464503MedicaidTX

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
I20120919000317 TX Practitioner - Nurse Practitioner 2668620584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nluc PLLCGroup PAC ID 3072752302, 219 clinicians
Next Level MV LLCGroup PAC ID 5991062085, 124 clinicians

Practice addresses (Care Compare)

101 Winding Way St
Suite a
Lake Jackson, TX 77566-5358
Phone (281) 783-8162

1246 N FM 3083 Rd W
Suite B
Conroe, TX 77304-5340
Phone (281) 783-8162

16312 Southwest Fwy
Sugar Land, TX 77479-2371
Phone (281) 783-8162

2560 E League City Pkwy
League City, TX 77573-6459
Phone (281) 783-8162

8100 Hwy 6 N
Suite E
Houston, TX 77095-1923
Phone (281) 783-8162

8325 Broadway St
Suite 220
Pearland, TX 77581-5773
Phone (281) 783-8162

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nluc PLLC Current Accepting new patients
Nluc PLLC CurrentSince Sep 1, 2019 Accepting new patients
Nluc PLLC CurrentSince Sep 1, 2019 Accepting new patients
Next Level MV LLC CurrentSince Sep 1, 2019 Accepting new patients
Next Level MV LLC CurrentSince Sep 1, 2019 Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Texas Em-I Medical Services, PA Past Accepting new patients
Emcare-Dtxemergency Physicians PLLC Nurse Practitioner Past Accepting new patients
Nluc PLLC Dba Next Level Urgent Care Past Accepting new patients

Locations

7710 Garth Rd
Ste A
Baytown, TX 77521

6342 Phelan Blvd
Beaumont, TX 77706
Phone (281) 783-7182

1246 N FM 3083 Rd W
Ste B
Conroe, TX 77304

8100 Highway 6 N
Ste E
Houston, TX 77095
Phone (832) 304-2314

101 Winding Way St
Ste A
Lake Jackson, TX 77566

8325 Broadway St
Ste 220
Pearland, TX 77581
Phone (281) 873-8162

4002 FM 762 Rd
Ste 100
Rosenberg, TX 77469

15882 Champion Forest Dr
Spring, TX 77379
Phone (281) 809-6615

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

Organizations & group practices 9

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1396009015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "address_2": "STE 5200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014612",
            "telephone_number": "214-712-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665674",
            "telephone_number": "979-297-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSY",
        "first_name": "HEIDI",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "654373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "881N41",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1396009015",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305464503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.