Individual provider Active NPI

Nelly Wakaria Mwaniki, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1578862694
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
732298 Issued in TX
Practice address
4701 Boat Club Rd Ste 200
Fort Worth, TX 76135-5285
Phone
(817) 237-0515
NPI assigned
Mar 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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 732298 TX Primary

Addresses

Primary practice location

4701 Boat Club Rd Ste 200
Fort Worth, TX 76135-5285

Mailing address

4701 Boat Club Rd Ste 200
Fort Worth, TX 76135-5285
Phone (817) 237-0515

Other practice location 1

10 Dorrance St Ste 700
Providence, RI 02903-2014
Phone (401) 240-1385

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nmwaniki1288316@direct.texashealth.org Health Information Exchange (HIE)

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
I20130507000110 TX Practitioner - Nurse Practitioner 8729249701 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC CurrentSince Aug 1, 2025 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Jan 30, 2013 Accepting new patients
Texas Health Physicians Group CurrentSince Jan 30, 2013 Accepting new patients

Locations

3707 E Southern Ave
#1
Mesa, AZ 85206
Phone (424) 387-6806

1015 15th St NW
Ste 1000
Washington, DC 20005
Phone (833) 815-2200

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

170 Commerce Way
Ste 2003113
Portsmouth, NH 03801

500 Marquette Ave NW
Ste 1200
Albuquerque, NM 87102
Phone (505) 295-6685

10 Dorrance St
Ste 700
Providence, RI 02903
Phone (401) 200-8242

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

4500 Mercantile Plaza Dr
Ste 300
Ft Worth, TX 76137
Phone (469) 688-9501

4701 Boat Club Rd
Ste 200
Ft Worth, TX 76135
Phone (817) 237-0515

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

180 N University Ave
Ste 270
Provo, UT 84601
Phone (385) 469-3731

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Interoperability endpoints

  • Direct secure messaging: nmwaniki1288316@direct.texashealth.org
  • Direct secure messaging: nelly.mwaniki.1@30520.direct.athenahealth.com

Organizations & group practices 4

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": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1578862694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 BOAT CLUB RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761355285",
            "telephone_number": "817-237-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 BOAT CLUB RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761355285",
            "telephone_number": "817-237-0515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Dorrance St Ste 700",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029032014",
            "country_code": "US",
            "telephone_number": "401-240-1385",
            "fax_number": "515-864-0259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWANIKI",
        "first_name": "NELLY",
        "middle_name": "WAKARIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "732298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmwaniki1288316@direct.texashealth.org",
            "affiliation": "N",
            "endpointDescription": "hie",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4701 Boat Club Rd Ste 200",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761355285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.