Individual provider Active NPI

Kristi Vergena Mizelle, M.D.

  • Rheumatology Physician
  • Spring, TX
National Provider Identifier
1457490955
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
LT24409 Issued in ND
Practice address
19740 Interstate 45 N
Spring, TX 77373-2941
Phone
(972) 798-8553
Fax
(972) 798-8556
NPI assigned
Feb 5, 2007
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X LT24409 ND Primary

Addresses

Primary practice location

19740 Interstate 45 N
Spring, TX 77373-2941

Mailing address

981 State Highway 121 Ste 3150
Allen, TX 75013-6151
Phone (972) 798-8553

Other identifiers 1

IdentifierTypeStateIssuer
051642200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, ND2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131009000107 VA Practitioner - Rheumatology 9032378674 Reassigns benefits to 1 organization
I20260603003541 ND Practitioner - Rheumatology 9032378674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Virginia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LT24409NDMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Sep 1, 2013 Accepting new patients
Cheyenne Regional Physicians Group, LLC CurrentSince Oct 6, 2025 Accepting new patients
Tidewater Physicians Multispecialty Group PC Rheumatology CurrentSince Sep 1, 2013 Accepting new patients
Cheyenne Children's Clinic, PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

704 Thimble Shoals Blvd
Ste 300A
Newport News, VA 23606
Phone (757) 595-4300

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

860 Omni Blvd
Ste 105
Newport News, VA 23606
Phone (757) 873-0952

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

2301 House Ave
Ste 201
Cheyenne, WY 82001
Phone (307) 635-9131

4116 Laramie St
Cheyenne, WY 82001
Phone (307) 634-9311

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1457490955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 STATE HIGHWAY 121 STE 3150",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136151",
            "telephone_number": "972-798-8553",
            "fax_number": "972-798-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19740 INTERSTATE 45 N",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773732941",
            "telephone_number": "972-798-8553",
            "fax_number": "972-798-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZELLE",
        "first_name": "KRISTI",
        "middle_name": "VERGENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "ND",
            "license": "LT24409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051642200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.