Individual provider Active NPI

Michelle Monson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1861110629
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1086705 Issued in TX
Practice address
4245 N Central Expy Ste 490
Dallas, TX 75205-4231
Phone
(972) 454-4511
Fax
(972) 808-6771
NPI assigned
Aug 18, 2022
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 73901 ID
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10030790 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1086705 TX Primary

Addresses

Primary practice location

4245 N Central Expy Ste 490
Dallas, TX 75205-4231

Mailing address

4245 N Central Expy Ste 490
Dallas, TX 75205-4231
Phone (972) 454-4511

Other practice location 1

800 W Main St Ste 1460
Boise, ID 83702-5983
Phone (972) 454-4511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221115000849 ID Practitioner - Nurse Practitioner 9032587563 Reassigns benefits to 2 organizations
I20240813003232 TX Practitioner - Nurse Practitioner 9032587563

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10030790ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerize Psychiatry PLLC CurrentSince Sep 1, 2024 Accepting new patients
Rurban PLLC CurrentSince Sep 1, 2024 Accepting new patients
Bella Family Healthcare & Aesthetics CurrentSince Oct 1, 2022 Accepting new patients
Locust Grove Womens Health PLLC PastSince Aug 1, 2022 Accepting new patients

Locations

1545 E Leigh Field Dr
Ste 100
Meridian, ID 83646

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1861110629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 N CENTRAL EXPY STE 490",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752054231",
            "telephone_number": "972-454-4511",
            "fax_number": "972-808-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 N CENTRAL EXPY STE 490",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752054231",
            "telephone_number": "972-454-4511",
            "fax_number": "972-808-6771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W Main St Ste 1460",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837025983",
            "country_code": "US",
            "telephone_number": "972-454-4511",
            "fax_number": "972-808-6771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONSON",
        "first_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "73901",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10030790",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1086705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.