Individual provider Active NPI

Kristen Nicole Herzog, MSN, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1184266538
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP143543 Issued in TX
Practice address
1644 W 13TH St
Houston, TX 77008-6451
Phone
(281) 844-0294
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP143543 TX Primary

Addresses

Primary practice location

1644 W 13TH St
Houston, TX 77008-6451

Mailing address

1644 W 13TH St
Houston, TX 77008-6451
Phone (281) 844-0294

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
I20200407003990 TX Practitioner - Nurse Practitioner 1052740313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group CurrentSince Mar 26, 2020 Accepting new patients

Locations

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 1

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": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1184266538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 W 13TH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770086451",
            "telephone_number": "281-844-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 W 13TH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770086451",
            "telephone_number": "281-844-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP143543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.