MONALISA CHURCHMAN (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1043080104

MONALISA CHURCHMAN (NP) is a healthcare provider. based in Live oak, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 1143500 (TX). The NPI Number for MONALISA CHURCHMAN (NP) is 1043080104

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MONALISA CHURCHMAN (NP)
NPI
1043080104
Phone
(210) 742-6551
Address
12881 N IH 35
Enumeration Date
8 January 2024
Last Update Date
13 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2107426555
Graduation Year
2023 (3 years ago)
PAC ID
8527403336
Group Practice PAC ID
0648530386
Professional Enrollment ID
I20240304000745
Address ID
TX782333230LI12410RDXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for MONALISA CHURCHMAN (NP)

  • 12881 N IH 35

    LIVE OAK, TX 782332966

    Phone: (210) 742-6551

    Fax: (210) 714-0744

    Type: Mailing

  • 1009 NW LOOP 410

    SAN ANTONIO, TX 782132221

    Phone: (210) 742-6551

    Fax: (210) 714-0744

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 42 Open Payments records for all available years, with a total value of $867.

Total Amount is formed as General ($867) + Research ($0) + Ownership ($0) = $867.

Last reported payment date: 2024-12-06 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($414).

Total Amount

$867

General + Research + Ownership

Payments

42

Total payment records

General Amount

$867

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-06

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240304000745INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78233)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648530386View full group profile
NameSpecialtyState
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Internal MedicineTX
Physician AssistantTX
-WV
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I use this page to confirm MONALISA CHURCHMAN (NP)'s NPI?
Yes. MONALISA CHURCHMAN (NP) is listed with NPI 1043080104 in the public NPI dataset.
Does CMS list MONALISA CHURCHMAN (NP) as active?
Yes — MONALISA CHURCHMAN (NP) is active in the NPI listing used on this page.
What is MONALISA CHURCHMAN (NP)'s primary classification?
Psychiatric/Mental Health Nurse Practitioner is the headline specialty for MONALISA CHURCHMAN (NP) here. Clinical services aligned with this taxonomy classification.
Where should I expect MONALISA CHURCHMAN (NP) on a map?
Expect Live Oak, Texas as a primary anchor for MONALISA CHURCHMAN (NP) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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