Individual provider Active NPI

Traci Doerre

  • Nurse Practitioner
  • Fredericksburg, TX
National Provider Identifier
1053859819
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP133037 Issued in TX
Practice address
205 W Windcrest Dr
Fredericksburg, TX 78624-4479
Phone
(830) 388-7785
Fax
(830) 218-0363
NPI assigned
Feb 1, 2017
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP133037 TX Primary
Gerontology Nurse Practitioner 363LG0600X AP133037 TX
Primary Care Nurse Practitioner 363LP2300X AP133037 TX

Addresses

Primary practice location

205 W Windcrest Dr
Fredericksburg, TX 78624-4479

Mailing address

250 Cully Dr
Kerrville, TX 78028-5950
Phone (830) 258-7288

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
I20170518000084 TX Practitioner - Nurse Practitioner 9739456914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Physician Group PLLCGroup PAC ID 5890155592, 16 clinicians

Practice addresses (Care Compare)

205 W Windcrest St
Suite 130
Fredericksburg, TX 78624-4478
Phone (830) 990-1404

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP133037TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Medical Associates CurrentSince Oct 10, 2017 Accepting new patients
South Texas Physician Group, PLLC CurrentSince May 6, 2023 Accepting new patients
Nocturna of Waco LP PastSince Feb 1, 2017 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1020 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 990-1555

551 Hill Country Dr
Kerrville, TX 78028
Phone (830) 257-5414

823 Junction Hwy
Kerrville, TX 78028
Phone (830) 258-6300

Interoperability endpoints

  • Direct secure messaging: traci.doerre@hca7.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1053859819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CULLY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285950",
            "telephone_number": "830-258-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W WINDCREST DR",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244479",
            "telephone_number": "830-388-7785",
            "fax_number": "830-218-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERRE",
        "first_name": "TRACI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP133037",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP133037",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP133037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.