Individual provider Active NPI

Miranda K Cheib, C-NP

  • Family Nurse Practitioner
  • Southlake, TX
National Provider Identifier
1497553002
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1190239 Issued in TX
Practice address
1545 E Southlake Blvd Ste 140
Southlake, TX 76092-6464
Phone
(817) 332-7867
NPI assigned
Mar 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1190239 TX Primary

Addresses

Primary practice location

1545 E Southlake Blvd Ste 140
Southlake, TX 76092-6464

Mailing address

1701 River Run Ste 302
Fort Worth, TX 76107-6547
Phone (281) 203-5006

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
I20260414002731 TX Practitioner - Nurse Practitioner 7315413762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Bridges PLLCGroup PAC ID 3476779711, 6 clinicians

Practice addresses (Care Compare)

5527 FM
Suite 636
Kerens, TX 75144-4001
Phone 81768791386

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1190239TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nobility Medical PLLC PastSince Jun 1, 2025 Accepting new patients
Jill Gramer DO PA PastSince Jun 1, 2025 Accepting new patients

Organizations & group practices 3

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": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1497553002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 RIVER RUN STE 302",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076547",
            "telephone_number": "281-203-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 E SOUTHLAKE BLVD STE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926464",
            "telephone_number": "817-332-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEIB",
        "first_name": "MIRANDA",
        "middle_name": "K",
        "credential": "C-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1190239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.