Individual provider Active NPI

Amy Katherine Haverty, PNP

  • Pediatric Nurse Practitioner
  • Galveston, TX
National Provider Identifier
1003019969
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP115846 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-5302
Phone
(409) 772-2222
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP115846 TX Primary
Pediatric Nurse Practitioner 363LP0200X 660544 TX

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-5302

Mailing address

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071203000110 TX Practitioner - Nurse Practitioner 7012006844 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP115846TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince May 4, 2016 Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

218 E House St
Alvin, TX 77511
Phone (281) 585-2530

2327 E Mulberry St
Angleton, TX 77515
Phone (979) 848-1886

128 W Parkwood Ave
Friendswood, TX 77546
Phone (281) 482-5695

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2240 Gulf Fwy S
Fl 4
League City, TX 77573
Phone (832) 505-1234

17448 Highway 3
Ste 200
Webster, TX 77598
Phone (832) 505-1748

Interoperability endpoints

  • Direct secure messaging: ahavertypnp1631@direct.utmb.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1003019969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERTY",
        "first_name": "AMY",
        "middle_name": "KATHERINE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP115846",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "660544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.