Medi- Elite, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MEDI- ELITE, PC

Practice address

2721 Central Dr
Bedford, TX 76021-4810

Phone

(682) 703-8881

Fax

(706) 203-3259

NPI assigned

Feb 3, 2012

Last updated

Nov 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mahalia L Jackson-Butler, DNP, APRNNPI 1063669893

Title

Ceo

Phone

(214) 277-2243

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mahalia L Jackson-Butler, DNP, APRN

  • Primary Care Nurse Practitioner
  • Bedford, TX
  • NPI 1063669893
  Medicare reassignment Care Compare group Authorized official
• Peris B Momanyi

  • Family Nurse Practitioner
  • Grand Prairie, TX
  • NPI 1194533356
  Medicare reassignment Care Compare group NPD
• Mariel Eloisa Yumul, FNP

  • Primary Care Nurse Practitioner
  • Bedford, TX
  • NPI 1780555201

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Shelley Renee Reed-Pouncy, APRN-CNP

  • Family Nurse Practitioner
  • Fort Worth, TX
  • NPI 1588470272

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732406400000",
    "number": "1528330792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 S COOPER ST STE 131-717",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760175866",
            "telephone_number": "214-277-2243",
            "fax_number": "214-231-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 CENTRAL DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760214810",
            "telephone_number": "682-703-8881",
            "fax_number": "706-203-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI- ELITE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON-BUTLER",
        "authorized_official_first_name": "MAHALIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-277-2243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "TX",
            "license": "AP117597",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "AP117597",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP117597",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP117597",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "TX",
            "license": "AP117597",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP117597",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Lynn McPherson, LPC
• John Patrick McPhillips, D.D.S., M.D
• Dovie McVean, PA-C
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• Christopher Mejia
• Robert G. Meltzer, MD
• Sonya Cooper Melville, MD

• Primary Care Clinic/Center in Bedford, TX
• Providers in Bedford, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.