Individual provider Active NPI

Nibras Talib Mamury

  • Physical Medicine & Rehabilitation Physician
  • Amarillo, TX
National Provider Identifier
1770080921
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
T2990 Issued in TX
Practice address
1215 S Coulter St Ste 403
Amarillo, TX 79106-1769
Phone
(806) 358-8331
Fax
(806) 356-0045
NPI assigned
Apr 12, 2018
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T2990 TX
Physical Medicine & Rehabilitation Physician 208100000X T2990 TX Primary

Addresses

Primary practice location

1215 S Coulter St Ste 403
Amarillo, TX 79106-1769

Mailing address

1215 S Coulter St Ste 400
Amarillo, TX 79106-1769
Phone (806) 358-8331

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210823003314 TX Practitioner - Internal Medicine 1658620737 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

1501 S Coulter St
Northwest Texas Heatlhcare System
Amarillo, TX 79106-1770
Phone (806) 354-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adnan Medical Services PLLC Internal Medicine CurrentSince May 9, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Aug 6, 2021 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Aug 6, 2021 Accepting new patients
Northwest Texas Healthcare System Inc Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150

7200 W 9th Ave
Amarillo, TX 79106
Phone (806) 468-2900

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1770080921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 S COULTER ST STE 400",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061769",
            "telephone_number": "806-358-8331",
            "fax_number": "806-356-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 S COULTER ST STE 403",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061769",
            "telephone_number": "806-358-8331",
            "fax_number": "806-356-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALIB MAMURY",
        "first_name": "NIBRAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T2990",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "T2990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.