MEDICARE: CHERISHE PAYNE MONDICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2026003639	MO
2	363LF0000X	Family Nurse Practitioner	AP70002806	WA
3	363LF0000X	Family Nurse Practitioner	53-85356-092	KS
4	363LF0000X	Family Nurse Practitioner	10043152	OR
5	363LF0000X	Family Nurse Practitioner	AP1017566	TX
6	163W00000X	Registered Nurse	10043152	OR
7	163W00000X	Registered Nurse	812095	TX
8	363LF0000X	Family Nurse Practitioner	334943	AZ

General Provider Information

NPI Number	:	1851988604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERISHE PAYNE MONDICS

Provider Business Mailing Address
First Line	:	15301 SPECTRUM DR STE 330
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-6462
Country	:	US
Telephone Number	:	806-239-5716
Fax Number	:

Provider Business Practice Location Address
First Line	:	15301 SPECTRUM DR STE 330
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-6462
Country	:	US
Telephone Number	:	806-239-5716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2020
Last Update Date	:	05/20/2026

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Directions to “ CHERISHE PAYNE MONDICS ” Practice Location

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