Individual provider Active NPI

Mika M'Laine Moore, APRN

  • Family Nurse Practitioner
  • Montgomery, TX
National Provider Identifier
1851855985
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140042 Issued in TX
Practice address
123 Blue Heron Dr
Montgomery, TX 77316-3192
Phone
(936) 290-0761
Fax
(936) 666-4618
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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 AP140042 TX Primary

Addresses

Primary practice location

123 Blue Heron Dr
Montgomery, TX 77316-3192

Mailing address

123 Blue Heron Dr
Montgomery, TX 77316-3192
Phone (936) 290-0761

Other practice location 1

Family First Urgent Care
2510 S Loop 336 W Suite 115
Conroe, TX 77304
Phone (936) 235-2825

Other names 1

  • Mika Lechler Former name

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
I20200402000114 TX Practitioner - Nurse Practitioner 8729417399 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Care of Montgomery PLLCGroup PAC ID 4082087754, 3 clinicians
C 2 K Health and Wellness PLLCGroup PAC ID 2264711449, 9 clinicians

Practice addresses (Care Compare)

123 Blue Heron Dr
Suite 101
Montgomery, TX 77316-3192
Phone (936) 290-0761

2510 S Loop 336
Suite 115
Conroe, TX 77304-3737
Phone (936) 235-2825

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP140042TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care of Montgomery PLLC Family CurrentSince Aug 1, 2024 Accepting new patients
C 2 K Health and Wellness PLLC Family CurrentSince Nov 9, 2021 Accepting new patients
Global Open Wound Care PLLC Family CurrentSince Feb 1, 2023 Accepting new patients
Global Open Wound Care Services LLC Family PastSince Jan 26, 2025 Accepting new patients

Locations

14420 Highway 105 E
Ste 104
Conroe, TX 77306
Phone (936) 235-2825

2510 S Loop 336 W
Ste 115A
Conroe, TX 77304

2510 S Loop 336 W
Ste 115
Conroe, TX 77304
Phone (936) 235-2825

123 Blue Heron Dr
Ste 101
Montgomery, TX 77316
Phone (936) 290-0761

250 Miron Dr
Southlake, TX 76092
Phone (817) 328-3000

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1851855985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-290-0761",
            "fax_number": "936-666-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-290-0761",
            "fax_number": "936-666-4618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Family First Urgent Care",
            "address_2": "2510 S Loop 336 W Suite 115",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "77304",
            "country_code": "US",
            "telephone_number": "936-235-2825",
            "fax_number": "936-235-2826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MIKA",
        "middle_name": "M'LAINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKA",
            "last_name": "LECHLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, TX

Sources for this page

Verify at the official NPI Registry.