Individual provider Active NPI

Renee Mieselle Lies, APRN

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1669083077
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP145584 Issued in TX
Practice address
2602 McKinney Ave Ste 115
Dallas, TX 75204-0727
Phone
(469) 729-7928
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP145584 TX
Adult Health Nurse Practitioner 363LA2200X AP145584 TX Primary
Nurse Practitioner 363L00000X AP145584 TX

Addresses

Primary practice location

2602 McKinney Ave Ste 115
Dallas, TX 75204-0727

Mailing address

4310 Deere St
Dallas, TX 75204-3608
Phone (214) 901-4112

Other practice location 1

7777 Forest Ln
Dallas, TX 75230-2571
Phone (972) 566-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211021001048 TX Practitioner - Nurse Practitioner 0840688008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.37 of 100Reported as group
Quality
68.64
Promoting interoperability
99
Improvement activities
40
Cost
73.42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartplace, PLLC CurrentSince Feb 9, 2026 Accepting new patients
Heartplace, PLLC CurrentSince Feb 9, 2026 Accepting new patients
Heartplace, PLLC Past Accepting new patients
Physicians Wellness Associates PLLC PastSince Aug 23, 2020 Accepting new patients

Locations

902 W Randol Mill Rd
Ste 200
Arlington, TX 76012
Phone (817) 461-3003

1924 Forest Ridge Dr
Ste 400
Bedford, TX 76021
Phone (817) 551-7707

399 W Campbell Rd
Ste 300
Richardson, TX 75080
Phone (972) 665-9100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14273/brand/6/csg/1/fhir/r4

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1669083077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 DEERE ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043608",
            "telephone_number": "214-901-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 MCKINNEY AVE STE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752040727",
            "telephone_number": "469-729-7928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Forest Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752302571",
            "country_code": "US",
            "telephone_number": "972-566-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIES",
        "first_name": "RENEE",
        "middle_name": "MIESELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP145584",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP145584",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP145584",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.