Individual provider Active NPI

Kiery Ann McMullen, FNP

  • Family Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1720477649
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP127246 Issued in TX
Practice address
901 N. Galloway Ave # 107
Mesquite, TX 75149-7418
Phone
(972) 216-5152
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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 AP127246 TX Primary

Addresses

Primary practice location

901 N. Galloway Ave # 107
Mesquite, TX 75149-7418

Mailing address

6875 Avalon Ave
Dallas, TX 75214-3776
Phone (903) 278-1432

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
I20150806011420 TX Practitioner - Nurse Practitioner 0446564280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salma Mazhar M.D. P.a.Group PAC ID 9133267917, 4 clinicians

Practice addresses (Care Compare)

1210 N Galloway Ave
Mesquite, TX 75149-2438
Phone (972) 216-5152

Hospital & facility affiliations

  • Baylor Scott and White Medical Center Sunnyvale Hospital, Sunnyvale, TX, CCN 670060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Salma Mazhar M.D. P.a. CurrentSince Jun 7, 2015 Accepting new patients

Locations

1210 N Galloway Ave
Mesquite, TX 75149
Phone (972) 216-5152

901 N Galloway Ave
Ste 107
Mesquite, TX 75149
Phone (972) 216-5152

Interoperability endpoints

  • Direct secure messaging: kiery.glover.1@2235.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1720477649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6875 AVALON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143776",
            "telephone_number": "903-278-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N. GALLOWAY AVE # 107",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751497418",
            "telephone_number": "972-216-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "KIERY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.