Kinzi Lea Self, APRN, AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1194805 Issued in TX

Practice address

4525 Heritage Trace Pkwy Ste 117
Fort Worth, TX 76244-8910

Phone

(817) 267-6290

Fax

(817) 267-0950

NPI assigned

May 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid Cities Neurology Associates, P.a.Group PAC ID 0749379592, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenzi.self.1@29952.direct.athenahealth.com

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.

• Mid Cities Neurology Associates, P.a.

  • Neurology Physician
  • Bedford, TX
  • NPI 1023119336
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1932948189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 HARWOOD RD STE 100",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760213703",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 HERITAGE TRACE PKWY STE 117",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448910",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Harwood Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "TX",
            "postal_code": "760213703",
            "country_code": "US",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELF",
        "first_name": "KINZI",
        "middle_name": "LEA",
        "credential": "APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1194805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenzi.self.1@29952.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address - used for all locations",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3030 Harwood Rd Ste 100",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760213703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenzi.self.1@29952.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address - used for all locations",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4525 Heritage Trace Pkwy Ste 117",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762448910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Select Ambulatory Surgery Center of Ft Worth LLC
• Select Physical Therapy Holdings, Inc.
• Select Physical Therapy Texas Limited Partnership
• Self Richard Dba
• Angela Donna Self, MD
• Lana Self, LPC
• Matthew Thomas Seliga, DPT
• Christina Sellers, M.S. CCC-SLP
• Deborah Wilson Sellers, CRNA
• Kara J Sellers, M.D.

• Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.