Individual provider Active NPI

Michelle Amy Coffey, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1417407149
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
67688 Issued in NM
Practice address
3621 22ND St
Suite 400
Lubbock, TX 79410-1301
Phone
(806) 791-8484
Fax
(806) 794-8499
NPI assigned
Oct 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP132467 TX
Acute Care Nurse Practitioner 363LA2100X AP132467 TX
Acute Care Nurse Practitioner 363LA2100X 2025019557 MO
Acute Care Nurse Practitioner 363LA2100X 67688 NM Primary

Addresses

Primary practice location

3621 22ND St
Suite 400
Lubbock, TX 79410-1301

Mailing address

3420 22ND PL
Lubbock, TX 79410-1314
Phone (806) 725-5844

Other practice location 1

703 S Fleishel Ave Ste 5000
Tyler, TX 75701-2015
Phone (903) 606-7587

Other practice location 2

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 606-7587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20161228000854 TX Practitioner - Nurse Practitioner 2567743859 Reassigns benefits to 2 organizations
I20230406002762 NM Practitioner - Nurse Practitioner 2567743859 Reassigns benefits to 1 organization
I20250717001506 MO Practitioner - Nurse Practitioner 2567743859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

3621 22ND St
Lubbock, TX 79410-1301
Phone (806) 791-8484

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67688NMMDAcute Care Nurse Practitioner
AP132467TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jun 15, 2025 Accepting new patients
SSM Health Care Group CurrentSince Jun 15, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 4, 2021 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 4, 2021 Accepting new patients
Unm Medical Group Inc CurrentSince Nov 24, 2022 Accepting new patients
Unm Medical Group, Inc. CurrentSince Nov 24, 2022 Accepting new patients

Locations

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

703 S Fleishel Ave
Ste 5000
Tyler, TX 75701
Phone (903) 525-2992

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1417407149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101314",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 22ND ST",
            "address_2": "SUITE 400",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101301",
            "telephone_number": "806-791-8484",
            "fax_number": "806-794-8499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 S Fleishel Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-606-7587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-7587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "MICHELLE",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132467",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132467",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2025019557",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "67688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.