NPIMap

Individual provider Active NPI

Kristina Jean Prater, FNP-C

  • Nurse Practitioner
  • Sonora, TX
National Provider Identifier
1093318669
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1019613 Issued in TX
Practice address
308 Hudspeth St
Sonora, TX 76950-8003
Phone
(325) 387-2521
Fax
(325) 387-2396
NPI assigned
Nov 17, 2020
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1019613 TX Primary

Addresses

Primary practice location

308 Hudspeth St
Sonora, TX 76950-8003

Mailing address

PO Box 455
Sonora, TX 76950-0455
Phone (325) 387-2521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120002572 TX Practitioner - Nurse Practitioner 4789098401 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Hospital Leasing Eldorado, IncGroup PAC ID 5799707618, shared by 4 NPIs, 5 clinicians

Practice addresses (Care Compare)

102 N US Hwy 277
Eldorado, TX 76936-4010
Phone (325) 853-2507

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1019613TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Hospital Leasing Eldorado, Inc. Current Accepting new patients
Preferred Hospital Leasing Eldorado, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Preferred Hospital Leasing Eldorado, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Preferred Hospital Leasing Eldorado Inc Past Accepting new patients

Locations

100 N US Highway 277
Eldorado, TX 76936
Phone (325) 853-2507

102 N US Highway 277
Eldorado, TX 76936
Phone (325) 853-2507

Organizations & group practices 5

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 4

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": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1093318669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 455",
            "city": "SONORA",
            "state": "TX",
            "postal_code": "769500455",
            "telephone_number": "325-387-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 HUDSPETH ST",
            "city": "SONORA",
            "state": "TX",
            "postal_code": "769508003",
            "telephone_number": "325-387-2521",
            "fax_number": "325-387-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATER",
        "first_name": "KRISTINA",
        "middle_name": "JEAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1019613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, TX

Sources for this page

Verify at the official NPI Registry.