Individual provider Active NPI

Mingxia Michelle Shi, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Irving, TX
National Provider Identifier
1669764072
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD.38534 Issued in AL
Practice address
4770 Regent Blvd
Irving, TX 75063-2445
Phone
(972) 934-4300
NPI assigned
May 4, 2011
Last updated
Dec 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 207534 LA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD.38534 AL Primary

Addresses

Primary practice location

4770 Regent Blvd
Irving, TX 75063-2445

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3614
Phone (214) 932-8029

Other identifiers 1

IdentifierTypeStateIssuer
2144570MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AL, TX3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160526001765 LA Practitioner - Pathology 1658674429 Reassigns benefits to 1 organization
I20190925002430 AL Practitioner - Pathology 1658674429 Reassigns benefits to 2 organizations
I20220628000475 TX Practitioner - Pathology 1658674429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.38534ALMDAnatomic Pathology & Clinical Pathology Physician
207534LAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Dec 1, 2016 Accepting new patients
University of South Alabama Mitchell Cancer Institute CurrentSince Sep 1, 2019 Accepting new patients
USA Health - Mci Business Services LLC CurrentSince Oct 9, 2021 Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology Current Accepting new patients
University of South Alabama Anatomic Pathology & Clinical Pathology CurrentSince Sep 1, 2019 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Oct 1, 2019 Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology Current Accepting new patients
University of South Alabama Anatomic Pathology & Clinical Pathology Current Accepting new patients
USA Health Physician Billing Services LLC Anatomic Pathology & Clinical Pathology CurrentSince Oct 1, 2019 Accepting new patients
USA Health Physician Billing Services LLC Current Accepting new patients
DFW 501a Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jun 6, 2022 Accepting new patients
USA Health - Mci Business Services LLC Anatomic Pathology & Clinical Pathology CurrentSince Oct 9, 2021 Accepting new patients
University of South Alabama Current Accepting new patients
USA Health Physician Billing Services LLC Anatomic Pathology & Clinical Pathology PastSince Mar 1, 2021 Accepting new patients

Locations

1660 Spring Hill Ave
Mobile, AL 36604
Phone (251) 445-9616

1660 Spring Hill Ave
Ste 3069
Mobile, AL 36604
Phone (251) 445-8405

2451 University Hospital Dr
Fl 1
Mobile, AL 36617
Phone (251) 471-7790

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

4770 Regent Blvd
Irving, TX 75063
Phone (800) 824-6152

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

4401 Booth Calloway Rd
Richland Hls, TX 76180
Phone (817) 255-1000

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1669764072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "214-932-8029",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 REGENT BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632445",
            "telephone_number": "972-934-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "MINGXIA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "207534",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AL",
            "license": "MD.38534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2144570",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.