Individual provider Active NPI

Kristen Michelle Clayton, APRN

  • Family Nurse Practitioner
  • Decatur, TX
National Provider Identifier
1013673086
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1058073 Issued in TX
Practice address
800 Medical Center Dr Ste C
Decatur, TX 76234-3844
Phone
(940) 626-2110
Fax
(940) 626-2113
NPI assigned
Nov 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1058073 TX Primary

Addresses

Primary practice location

800 Medical Center Dr Ste C
Decatur, TX 76234-3844

Mailing address

2724 Flint Rock Dr
Fort Worth, TX 76131-2055
Phone (440) 454-9073

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
I20220701000068 TX Practitioner - Nurse Practitioner 3779963152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.4 of 100Reported as group
Quality
98.33
Improvement activities
40
Cost
76.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1058073TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christine Holland MD PA CurrentSince Mar 19, 2022 Accepting new patients
360 Cardiac Care PC CurrentSince Jul 1, 2023 Accepting new patients

Locations

800 Medical Center Dr
Ste C
Decatur, TX 76234
Phone (940) 626-2110

1866 Keller Pkwy
Ste B
Keller, TX 76248
Phone (682) 337-3810

4375 Booth Calloway Rd
Ste 210
North Richlnd Hls, TX 76180
Phone (817) 284-9797

8801 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 616-0700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCIGCD/Endpoint/DCIGCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCIGCD

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": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1013673086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 FLINT ROCK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761312055",
            "telephone_number": "440-454-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR STE C",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343844",
            "telephone_number": "940-626-2110",
            "fax_number": "940-626-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1058073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

Verify at the official NPI Registry.