Individual provider Active NPI

Boone Martin Mitchell

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1881540052
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
95927 Issued in TX
Practice address
5643 Cielo RNCH
San Antonio, TX 78218-4165
Phone
(325) 513-6016
NPI assigned
Mar 9, 2026
Last updated
Mar 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 95927 TX Primary

Addresses

Primary practice location

5643 Cielo RNCH
San Antonio, TX 78218-4165

Mailing address

5643 Cielo RNCH
San Antonio, TX 78218-4165
Phone (325) 513-6016

Other identifiers 1

IdentifierTypeStateIssuer
95927OtherTXLPC

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260317000608 TX Practitioner - Mental Health Counselor 0648753764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Trucare PAGroup PAC ID 1557643467, 17 clinicians

Practice addresses (Care Compare)

823 Ira E Woods Ave
Suite 200
Grapevine, TX 76051-4096
Phone (817) 722-6078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95927TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
MD Trucare PA CurrentSince Mar 3, 2026 Accepting new patients

Locations

10640 N Riverside Dr
Ste 300
Fort Worth, TX 76244
Phone (817) 722-6078

823 Ira E Woods Ave
Ste 200
Grapevine, TX 76051
Phone (817) 421-9999

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJHDBD

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, 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": "1773014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1881540052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5643 CIELO RNCH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782184165",
            "telephone_number": "325-513-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5643 CIELO RNCH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782184165",
            "telephone_number": "325-513-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BOONE",
        "middle_name": "MARTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "95927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "95927",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.