Individual provider Active NPI

Emily E Mohyde, FNP-C

  • Family Nurse Practitioner
  • Rosenberg, TX
National Provider Identifier
1689161614
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1014361 Issued in TX
Practice address
545 FM 2977 Rd Ste 110
Rosenberg, TX 77469-7507
Phone
(832) 930-8399
NPI assigned
Apr 16, 2018
Last updated
Jun 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209017454 IL
Family Nurse Practitioner 363LF0000X 1014361 TX Primary

Addresses

Primary practice location

545 FM 2977 Rd Ste 110
Rosenberg, TX 77469-7507

Mailing address

545 FM 2977 Rd Ste 110
Rosenberg, TX 77469-7507
Phone (708) 631-2781

Other practice location 1

12200 Western Ave
Blue Island, IL 60406-1398
Phone (708) 631-2781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180504001273 IL Practitioner - Nurse Practitioner 6507120201 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

1360 Houbolt Rd
Joliet, IL 60431-9215
Phone (815) 823-8800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209017454ILMDFamily Nurse Practitioner
1014361TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Jan 13, 2025 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Apr 15, 2018 Accepting new patients
Brazos Hybrid Pharmacy LLC CurrentSince May 21, 2021 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Apr 15, 2018 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Jan 13, 2025 Accepting new patients

Locations

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

12200 Western Ave
Ste 100
Blue Island, IL 60406
Phone (708) 631-2781

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

1360 Houbolt Rd
Joliet, IL 60431
Phone (815) 823-8800

3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

5801 S Transit Rd
Lockport, NY 14094
Phone (716) 280-6589

545 Minonite Rd
Ste 110
Rosenberg, TX 77469
Phone (832) 930-8399

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1689161614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 FM 2977 RD STE 110",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774697507",
            "telephone_number": "708-631-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 FM 2977 RD STE 110",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774697507",
            "telephone_number": "832-930-8399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12200 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Blue Island",
            "state": "IL",
            "postal_code": "604061398",
            "country_code": "US",
            "telephone_number": "708-631-2781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHYDE",
        "first_name": "EMILY",
        "middle_name": "E",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017454",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1014361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosenberg, TX

Sources for this page

Verify at the official NPI Registry.