Individual provider Active NPI

Charity A Espenlaub, APN

  • Gerontology Nurse Practitioner
  • Austin, TX
National Provider Identifier
1194276352
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
785613 Issued in TX
Practice address
7000 N Mo Pac Expy Ste 420
Austin, TX 78731-3055
Phone
(512) 482-0045
Fax
(512) 476-9892
NPI assigned
Oct 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 785613 TX
Gerontology Nurse Practitioner 363LG0600X 785613 TX Primary

Addresses

Primary practice location

7000 N Mo Pac Expy Ste 420
Austin, TX 78731-3055

Mailing address

7000 N Mo Pac Expy Ste 420
Austin, TX 78731-3055
Phone (512) 482-0045

Other identifiers 1

IdentifierTypeStateIssuer
3707531-02MedicaidTX

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
I20170524001174 TX Practitioner - Nurse Practitioner 8921375882 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
785613TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Davids Heart & Vascular, PLLC CurrentSince May 9, 2024 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

4316 James Casey St
Ste A
Austin, TX 78745
Phone (512) 481-1408

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

3801 N Lamar Blvd
#300
Austin, TX 78756
Phone (512) 206-3600

1900 Scenic Dr
Ste 3308
Georgetown, TX 78626
Phone (512) 244-2263

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": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1194276352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 N MO PAC EXPY STE 420",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313055",
            "telephone_number": "512-482-0045",
            "fax_number": "512-476-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 N MO PAC EXPY STE 420",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313055",
            "telephone_number": "512-482-0045",
            "fax_number": "512-476-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPENLAUB",
        "first_name": "CHARITY",
        "middle_name": "A",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-21",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "785613",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "785613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3707531-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.