JAMIE K MODRALL (FNP) – Family Nurse Practitioner, NPI 1336169002

JAMIE K MODRALL (FNP) is a healthcare provider. based in Mesquite, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 650239 (TX). The NPI Number for JAMIE K MODRALL (FNP) is 1336169002

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
JAMIE K MODRALL (FNP)
NPI
1336169002
Phone
(972) 686-1795
Address
18601 LYNDON B JOHNSON FWY STE 315
Enumeration Date
19 July 2006
Last Update Date
7 November 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024230396
Graduation Year
1998 (28 years ago)
PAC ID
2466577374
Group Practice PAC ID
7911003017
Professional Enrollment ID
I20181208000356
Address ID
NE685214162LI3740XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for JAMIE K MODRALL (FNP)

  • 18601 LYNDON B JOHNSON FWY STE 315

    MESQUITE, TX 751505612

    Phone: (972) 686-1795

    Fax: (972) 686-1798

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $53.

Total Amount is formed as General ($53) + Research ($0) + Ownership ($0) = $53.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: PFIZER INC. ($20).

Total Amount

$53

General + Research + Ownership

Payments

3

Total payment records

General Amount

$53

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2018-12-08

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
I20181208000356INurse PractitionerNETBD

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 75150)

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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: 7911003017View full group profile

Reviews

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Frequently asked questions

How do payers reference JAMIE K MODRALL (FNP)?
For JAMIE K MODRALL (FNP), use NPI 1336169002 as the unique 10-digit identifier.
Would JAMIE K MODRALL (FNP) appear as active to a payer?
You can treat JAMIE K MODRALL (FNP) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with JAMIE K MODRALL (FNP)?
JAMIE K MODRALL (FNP)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JAMIE K MODRALL (FNP)?
Travel planning: use Mesquite, Texas as the reference point for JAMIE K MODRALL (FNP), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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