Individual provider Active NPI

Kristen M Vitek

  • Pediatric Registered Nurse
  • Georgetown, TX
National Provider Identifier
1124597216
Registry record updated Nov 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
943587 Issued in TX
Practice address
118 Azalea Dr
Georgetown, TX 78626-4802
Phone
(512) 971-1720
NPI assigned
Nov 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 943587 TX Primary

Addresses

Primary practice location

118 Azalea Dr
Georgetown, TX 78626-4802

Mailing address

118 Azalea Dr
Georgetown, TX 78626-4802

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

State licenses

LicenseStateTypeSpecialty
943587TXMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1542499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542499200000",
    "number": "1124597216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 AZALEA DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786264802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 AZALEA DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786264802",
            "telephone_number": "512-971-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITEK",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-18",
        "last_updated": "2018-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "943587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2018; 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.