Individual provider Active NPI

Cindy Sue Petty, DNP

  • Family Nurse Practitioner
  • Corpus Christi, TX
National Provider Identifier
1053479337
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TX577955 Issued in TX
Practice address
4710 Everhart Rd Ste 100
Corpus Christi, TX 78411-2750
Phone
(361) 205-8126
Fax
(361) 277-6772
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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 TX577955 TX Primary

Addresses

Primary practice location

4710 Everhart Rd Ste 100
Corpus Christi, TX 78411-2750

Mailing address

4710 Everhart Rd
Ste 100
Corpus Christi, TX 78411-2750
Phone (361) 205-8126

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
I20080418000469 TX Practitioner - Nurse Practitioner 8022196823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4710 Everhart Rd
Suite 100
Corpus Christi, TX 78411-2750
Phone (361) 857-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TX577955TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Corpus Care Family CurrentSince Oct 4, 2007 Accepting new patients

Locations

4710 Everhart Rd
Ste 100
Corpus Christi, TX 78411
Phone (361) 205-8126

Organizations & group practices 1

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1053479337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 EVERHART RD",
            "address_2": "STE 100",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112750",
            "telephone_number": "361-205-8126",
            "fax_number": "361-277-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 EVERHART RD STE 100",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112750",
            "telephone_number": "361-205-8126",
            "fax_number": "361-277-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "CINDY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "TX577955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.