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MS. MARY MICHELLE LIVELY NP-C NPI 1114261401


NPI Information

NPI: 1114261401
Provider Name: MS. MARY MICHELLE LIVELY, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: HEALTHTEXAS PROVIDER NETWORK

PECOS Registration: Yes

Address:
8198 WALNUT HILL LN STE 100
DALLAS, TX
ZIP 75231
Phone: (214) 345-4449
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MS. Mary Michelle Lively, NP-C is a family nurse practitioner in Dallas, TX with 12 years of experience. MS. Mary Michelle Lively, NP-C NPI is 1114261401. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8198 WALNUT HILL LN STE 100
DALLAS, TX
ZIP 75231-316
Phone: (214) 345-4449
Fax: (214) 345-1238

The NPI 1114261401 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter (HCPCS:G0434)

The enumeration date for this NPI number is 11/27/2012 and was last updated on 9/20/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyAP122051TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1338206102MEDICAIDTEXAS
2276722YK99MEDICARE PINTEXAS
38543NHOTHERTEXASBCBS TX
4276722YK9HMEDICARE PINTEXAS
5338206103MEDICAIDTEXAS
6276722YKQLMEDICARE PINTEXAS
7276722YK8AMEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.