Active NPI
Shannon Ray Mueller, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Granbury, TX
National Provider Identifier
1528066255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- DPM 1659
- Practice address
- 1201 Medical Plaza CT
Granbury, TX 76048-5684 - Phone
- (817) 578-8555
- Fax
- (817) 573-6234
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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.
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 1999
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1201 Medical Plaza CT
Granbury, TX 76048-5684
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.38 of 100
- Quality
- 84.75
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 489 |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040110000071 | TX | Practitioner - Podiatry | 4183524002 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1659 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| DPM 1659 | TX | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brazos Foot and Ankle Clinic P.a. | Foot & Ankle Surgery | Current | Accepting new patients |
Locations
1201 Medical Plaza Ct
Granbury, TX 76048
Phone (817) 279-9044
Interoperability endpoints
- shannon.mueller@dm-tx.direct.office.nextgen.com
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | DPM 1659 | TX | Primary |
| Foot Surgery Podiatrist | 213ES0131X | DPM 1659 | TX |
Addresses
NPPES NPI RegistryPrimary practice location
1201 Medical Plaza CT
Granbury, TX 76048-5684
Mailing address
1201 Medical Plaza CT
Granbury, TX 76048-5684
Phone (817) 578-8555
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162842201 | Medicaid | TX |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 12, 2016.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455235200000",
"number": "1528066255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 MEDICAL PLAZA CT",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760485684",
"telephone_number": "817-578-8555",
"fax_number": "817-573-6234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 MEDICAL PLAZA CT",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760485684",
"telephone_number": "817-578-8555",
"fax_number": "817-573-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "SHANNON",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2016-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "TX",
"license": "DPM 1659",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "TX",
"license": "DPM 1659",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162842201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Granbury, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.