Individual provider Active NPI

Kristin Jenna Rattray, RN, MSN, NP-C

  • Family Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1093033284
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP118990 Issued in TX
Practice address
3501 S Soncy Rd
Suite 150
Amarillo, TX 79119-6407
Phone
(806) 212-6353
Fax
(806) 212-0558
NPI assigned
May 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 18979 TX
Registered Nurse 163W00000X 716269 TX
Family Nurse Practitioner 363LF0000X AP118990 TX Primary

Addresses

Primary practice location

3501 S Soncy Rd
Suite 150
Amarillo, TX 79119-6407

Mailing address

PO Box 840026
Dallas, TX 75284-0026
Phone (806) 212-6965

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
18979TXMDProfessional Counselor
716269TXMDRegistered Nurse
AP118990TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1093033284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840026",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840026",
            "telephone_number": "806-212-6965",
            "fax_number": "806-212-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S SONCY RD",
            "address_2": "SUITE 150",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196407",
            "telephone_number": "806-212-6353",
            "fax_number": "806-212-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTRAY",
        "first_name": "KRISTIN",
        "middle_name": "JENNA",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "18979",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "716269",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP118990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.