Individual provider Active NPI

Kiara Pegues

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1174132500
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1131908 Issued in TX
Practice address
103 SW Military Dr
San Antonio, TX 78221-1650
Phone
(866) 389-2727
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1131908 TX Primary

Addresses

Primary practice location

103 SW Military Dr
San Antonio, TX 78221-1650

Mailing address

103 SW Military Dr
San Antonio, TX 78221-1650

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
I20240402002724 TX Practitioner - Nurse Practitioner 3274930284 Reassigns benefits to 2 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
Minuteclinic Diagnostic of Texas PLLCGroup PAC ID 7416039177, 253 clinicians

Practice addresses (Care Compare)

103 SW Military Dr
San Antonio, TX 78221-1650
Phone (866) 389-2727

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Texas PLLC CurrentSince Oct 9, 2024 Accepting new patients
Minuteclinic Telehealth Services of Texas Association Family CurrentSince Oct 9, 2024 Accepting new patients
Minuteclinic Diagnostic of Texas PLLC Family CurrentSince Oct 9, 2024 Accepting new patients

Locations

1540 E Main St
Allen, TX 75002
Phone (214) 383-9765

5526 S Congress Ave
Austin, TX 78745
Phone (512) 462-3820

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

2469 Bay Area Blvd
Houston, TX 77058
Phone (281) 474-4042

3103 Fry Rd
Katy, TX 77449
Phone (281) 646-2964

5002 W Main St
League City, TX 77573
Phone (281) 557-4374

1413 Oates Dr
Mesquite, TX 75150
Phone (972) 613-7001

9522 Broadway St
Pearland, TX 77584
Phone (713) 436-8151

1855 Gattis School Rd
Round Rock, TX 78664
Phone (512) 238-6268

103 SW Military Dr
San Antonio, TX 78221
Phone (210) 927-6755

5301 Alamo Pkwy
San Antonio, TX 78253
Phone (210) 688-9311

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1174132500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SW MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SW MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211650",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUES",
        "first_name": "KIARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1131908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.