Individual provider Active NPI

Mary Massey, RN

  • Registered Nurse
  • Southlake, TX
National Provider Identifier
1629851639
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
786082 Issued in TX
Practice address
2845 Exchange Blvd Ste 140
Southlake, TX 76092-9135
Phone
(817) 505-3813
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 786082 TX Primary

Addresses

Primary practice location

2845 Exchange Blvd Ste 140
Southlake, TX 76092-9135

Mailing address

2845 Exchange Blvd Ste 140
Southlake, TX 76092-9135
Phone (817) 505-3813

Other practice location 1

2911 Wentwood Dr
Grapevine, TX 76051-3848
Phone (817) 505-3813

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
786082TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1629851639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 EXCHANGE BLVD STE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929135",
            "telephone_number": "817-505-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 EXCHANGE BLVD STE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929135",
            "telephone_number": "817-505-3813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2911 Wentwood Dr",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760513848",
            "country_code": "US",
            "telephone_number": "817-505-3813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "MARY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "786082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.