Individual provider Active NPI

Monica Booker, FNP

  • Nurse Practitioner
  • Caddo Mills, TX
National Provider Identifier
1790581064
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1014160 Issued in TX
Practice address
3667 County Road 2134 Ste C
Caddo Mills, TX 75135-6897
Phone
(903) 751-5550
Fax
(833) 973-3638
NPI assigned
Feb 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1014160 TX Primary

Addresses

Primary practice location

3667 County Road 2134 Ste C
Caddo Mills, TX 75135-6897

Mailing address

3667 County Road 2134 Ste C
Caddo Mills, TX 75135-6897
Phone (903) 751-5550

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
I20250617000513 TX Practitioner - Nurse Practitioner 7911418975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas a & M University System, HSC, College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive Family Care and Wellness, LLCGroup PAC ID 1456895432, 2 clinicians

Practice addresses (Care Compare)

3667 County Rd
2134 Suite C
Caddo Mills, TX 75135-6897
Phone (903) 751-5550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1014160TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Family Care & Wellness LLC CurrentSince Jun 11, 2025 Accepting new patients

Locations

3667 County Road 2134
Ste C
Caddo Mills, TX 75135
Phone (903) 751-5550

Interoperability endpoints

  • Direct secure messaging: monica.booker.1@31805.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.

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1790581064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3667 COUNTY ROAD 2134 STE C",
            "city": "CADDO MILLS",
            "state": "TX",
            "postal_code": "751356897",
            "telephone_number": "903-751-5550",
            "fax_number": "833-973-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3667 COUNTY ROAD 2134 STE C",
            "city": "CADDO MILLS",
            "state": "TX",
            "postal_code": "751356897",
            "telephone_number": "903-751-5550",
            "fax_number": "833-973-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "MONICA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1014160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caddo Mills, TX

Sources for this page

Verify at the official NPI Registry.