Individual provider Active NPI

Kareen Elliott, APRN, CPNP PC

  • Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1053906818
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1029910 Issued in TX
Practice address
7504 Bissonnet St # T9
Houston, TX 77074-5502
Phone
(832) 658-5260
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 1029910 TX Primary

Addresses

Primary practice location

7504 Bissonnet St # T9
Houston, TX 77074-5502

Mailing address

510 Dovecoft LN
Rosenberg, TX 77469-4778
Phone (281) 408-3089

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1029910TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imran Baig MD PA Single Specialty PastSince Mar 1, 2021 Accepting new patients
Bear Creek Pediatric Clinic PA Single Specialty PastSince Mar 1, 2021 Accepting new patients
Memorial Hermann Community Benefit Corporation PastSince Dec 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kelliott35102@memorialhermann.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1053906818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 DOVECOFT LN",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774694778",
            "telephone_number": "281-408-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 BISSONNET ST # T9",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770745502",
            "telephone_number": "832-658-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KAREEN",
        "credential": "APRN, CPNP PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1029910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.