Individual provider Active NPI

Kathryn Elizabeth Whitacre

  • Licensed Vocational Nurse
  • Boerne, TX
National Provider Identifier
1003791336
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
1128597 Issued in TX
Practice address
221 Farm Valley Dr
500
Boerne, TX 78006
Phone
(830) 249-9328
NPI assigned
Aug 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 1128597 TX Primary

Addresses

Primary practice location

221 Farm Valley Dr
500
Boerne, TX 78006

Mailing address

9222 Fishers Hill Dr
San Antonio, TX 78240-2838
Phone (830) 481-1629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1128597TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1003791336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9222 FISHERS HILL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782402838",
            "telephone_number": "830-481-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 FARM VALLEY DR",
            "address_2": "500",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "78006",
            "telephone_number": "830-249-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITACRE",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "1128597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.