Active NPI
Larry Eugene Kertner, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Dallas, TX
National Provider Identifier
1003792532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1208274
- Practice address
- 5200 Harry Hines Blvd.
Wish Building, 3Rd. Floor, 03-113, Second Door
Dallas, TX 75235 - Phone
- (469) 419-2323
- Fax
- (214) 590-2489
- NPI assigned
- Aug 12, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1208274 | TX | Primary |
Addresses
Primary practice location
5200 Harry Hines Blvd.
Wish Building, 3Rd. Floor, 03-113, Second Door
Dallas, TX 75235
Mailing address
5200 Harry Hines Blvd.
Wish Building, 3Rd. Floor, 03-113, Second Door
Dallas, TX 75235
Phone (469) 419-2323
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1208274 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1003792532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 HARRY HINES BLVD.",
"address_2": "WISH BUILDING, 3RD. FLOOR, 03-113, SECOND DOOR",
"city": "DALLAS",
"state": "TX",
"postal_code": "75235",
"telephone_number": "469-419-2323",
"fax_number": "214-590-2489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 HARRY HINES BLVD.",
"address_2": "WISH BUILDING, 3RD. FLOOR, 03-113, SECOND DOOR",
"city": "DALLAS",
"state": "TX",
"postal_code": "75235",
"telephone_number": "469-419-2323",
"fax_number": "214-590-2489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERTNER",
"first_name": "LARRY",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-12",
"last_updated": "2025-08-12",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "1208274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.