Vida Riston Sprott, APRN, CNM, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

540793 Issued in TX

Practice address

2965 Harrison St Ste 313
Beaumont, TX 77702-1113

Phone

(409) 838-4472

Fax

(877) 769-2234

NPI assigned

Oct 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

Practice roles

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.

• Maxie C Sprott II MD PA

  • Specialist
  • Beaumont, TX
  • NPI 1326134594
  Medicare reassignment Authorized official
• Vida Keller Riston RN CNM PC

  • Family Nurse Practitioner
  • Beaumont, TX
  • NPI 1255776498
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1023008265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 CALDER ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021916",
            "telephone_number": "409-838-4472",
            "fax_number": "409-838-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 HARRISON ST STE 313",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021113",
            "telephone_number": "409-838-4472",
            "fax_number": "877-769-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPROTT",
        "first_name": "VIDA",
        "middle_name": "RISTON",
        "credential": "APRN, CNM, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "540793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135029004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spinetech Surgery Center LLC
• Monica Spittler, LCDC
• Spring Creek Nursing and Rehabilitation LP
• Springleaf Health Medical, LP
• Maxie C Sprott II, M.D.
• Toben Richard Squires, PTA
• Sakuntalai Srinanthakumar, M.D.
• Sringleaf Medical, LTD
• Sriya Desilva
• SS Powers Dental, P.a.

• Nurse Practitioner in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.