Active NPI
Audra Coston, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Grand Prairie, TX
National Provider Identifier
1962012146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AP146041
- Practice address
- 1171 107TH St
Grand Prairie, TX 75050-2502 - Phone
- (972) 597-0843
- NPI assigned
- Aug 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP146041 | TX | Primary |
Addresses
Primary practice location
1171 107TH St
Grand Prairie, TX 75050-2502
Mailing address
1171 107TH St
Grand Prairie, TX 75050-2502
Phone (972) 597-0843
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 18, 2024 through Dec 18, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP146041 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1962012146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1171 107TH ST",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750502502",
"telephone_number": "972-597-0843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1171 107TH ST",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750502502",
"telephone_number": "972-597-0843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTON",
"first_name": "AUDRA",
"credential": "PMHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-03",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "AP146041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.