Individual provider Active NPI

Karina Gonzalez

  • Family Nurse Practitioner
  • Pearland, TX
National Provider Identifier
1114509734
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07210372 Issued in TX
Practice address
13807 Tidewater Crest LN
Pearland, TX 77584-4589
Phone
(832) 633-7146
NPI assigned
Apr 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 922155 TX
Nurse Practitioner 363L00000X 1076808 TX
Family Nurse Practitioner 363LF0000X F07210372 TX Primary

Addresses

Primary practice location

13807 Tidewater Crest LN
Pearland, TX 77584-4589

Mailing address

13807 Tidewater Crest LN
Pearland, TX 77584-4589
Phone (832) 633-7146

Other practice location 1

2002 S Wayside Dr Bldg B
Houston, TX 77023-3905
Phone (713) 803-1852

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
I20220914000207 TX Practitioner - Nurse Practitioner 1850776790 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
922155TXMDPediatric Registered Nurse
F07210372TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network CurrentSince Jun 6, 2022 Accepting new patients
C H Wilkinson Physician Network Nurse Practitioner CurrentSince Jun 6, 2022 Accepting new patients

Locations

2002 S Wayside Dr
#B
Houston, TX 77023
Phone (713) 803-1840

2120 S Wayside Dr
Ste B
Houston, TX 77023
Phone (713) 803-1840

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: karina.gonzalez.1@996.direct.athenahealth.com

Organizations & group practices 2

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": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1114509734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13807 TIDEWATER CREST LN",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844589",
            "telephone_number": "832-633-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13807 TIDEWATER CREST LN",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844589",
            "telephone_number": "832-633-7146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2002 S Wayside Dr Bldg B",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770233905",
            "country_code": "US",
            "telephone_number": "713-803-1852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "922155",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1076808",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F07210372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.