Individual provider Active NPI

Shannon Ray Mueller, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Granbury, TX
National Provider Identifier
1528066255
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM 1659 Issued in TX
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 100Reported as individual
Quality
84.75
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue489

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040110000071 TX Practitioner - Podiatry 4183524002 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1659NEMDAddiction (Substance Use Disorder) Counselor
DPM 1659TXMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Foot and Ankle Clinic P.a. Foot & Ankle Surgery CurrentSince Aug 15, 2003 Accepting new patients

Locations

1201 Medical Plaza Ct
Granbury, TX 76048
Phone (817) 279-9044

Interoperability endpoints

  • Direct secure messaging: shannon.mueller@dm-tx.direct.office.nextgen.com

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X DPM 1659 TX Primary
Foot Surgery Podiatrist 213ES0131X DPM 1659 TX

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
162842201MedicaidTX

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

Verify at the official NPI Registry.