Mystii Ellen Kidd, PNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP107293 Issued in TX

Practice address

4001 W 15TH St Ste 350
Plano, TX 75093-5863

Phone

(972) 596-2131

Fax

(682) 303-2031

NPI assigned

Aug 24, 2011

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 names 1

• Mystii Ellen Nekuza Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkidd175883@cookchildrens.direct-ci.com

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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1437439221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W 15TH ST STE 350",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935863",
            "telephone_number": "972-596-2131",
            "fax_number": "682-303-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "MYSTII",
        "middle_name": "ELLEN",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP107293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkidd175883@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4001 W 15th St Ste 350",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750935863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MYSTII",
            "last_name": "NEKUZA",
            "middle_name": "ELLEN",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigaile Kiarie
• Liane B Kibel, M.D.
• Steven John Kicinski, D.C.
• Kidability, PLLC
• Iseyas Kidane Tecie
• Kids Doc'S Pediatric Associates
• Kidwell Services LLC
• Jennifer Kieschnick, PT, DPT
• Andrea Shea Kiesling, CCC/SLP
• Steven Kight, P.T.

• Primary Care Nurse Practitioner in Plano, TX
• Providers in Plano, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.