Individual provider Active NPI

Mia Raiff

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1558219923
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1232648 Issued in TX
Practice address
6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone
(214) 633-5555
NPI assigned
Mar 20, 2026
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14272588-4405 UT
Acute Care Nurse Practitioner 363LA2100X 1232648 TX Primary

Addresses

Primary practice location

6201 Harry Hines Blvd
Dallas, TX 75235-5202

Mailing address

6548 Fisher Rd
Dallas, TX 75214-1631
Phone (937) 781-6144

Other practice location 1

3142 S Highland Dr Ste B5
Millcreek, UT 84106-4988
Phone (801) 893-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1232648TXMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1773964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1558219923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6548 FISHER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752141631",
            "telephone_number": "937-781-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355202",
            "telephone_number": "214-633-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3142 S Highland Dr Ste B5",
            "address_purpose": "LOCATION",
            "city": "Millcreek",
            "state": "UT",
            "postal_code": "841064988",
            "country_code": "US",
            "telephone_number": "801-893-3777",
            "fax_number": "385-308-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAIFF",
        "first_name": "MIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-20",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "14272588-4405",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1232648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.