Active NPI
Kristina Leah Reardon, CRNP
- Adult Health Nurse Practitioner
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 811965
- Practice address
- 800 5TH Ave Ste 500
Fort Worth, TX 76104-7304 - Phone
- (817) 250-4280
- NPI assigned
- Apr 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN567319 | PA | |
| Registered Nurse | 163W00000X | 811965 | TX | |
| Adult Health Nurse Practitioner | 363LA2200X | SP009505 | PA | |
| Adult Health Nurse Practitioner | 363LA2200X | 811965 | TX | Primary |
Addresses
Primary practice location
800 5TH Ave Ste 500
Fort Worth, TX 76104-7304
Mailing address
800 5TH Ave Ste 500
Fort Worth, TX 76104-7304
Phone (817) 250-4280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 316409704 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kng178352@Direct.TexasHealth.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
800 5TH Ave
Suite 500
Fort Worth, TX 76104-7304
Phone (817) 250-4280
Hospital & facility affiliations
- Texas Health Harris Methodist Fort Worth
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN567319 | PA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Health Physicians Group | Current | Accepting new patients | |
| Texas Health Physicians Group | Current | Accepting new patients | |
| Texas Health Physicians Group | Current | Accepting new patients |
Locations
1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803
4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500
1325 Pennsylvania Ave
Ste 890
Ft Worth, TX 76104
Phone (817) 250-4280
800 5th Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 250-4280
800 5th Ave
Ft Worth, TX 76104
Phone (214) 506-2660
341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996
Interoperability endpoints
- kng178352@direct.texashealth.org
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.
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1174573596
-
- Sleep Disorder Diagnostic Clinic/Center
- Fort Worth, TX
- NPI 1114395969
-
- Sleep Disorder Diagnostic Clinic/Center
- Dallas, TX
- NPI 1174992051
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1336172105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645401600000",
"number": "1205079464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 5TH AVE STE 500",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761047304",
"telephone_number": "817-250-4280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 5TH AVE STE 500",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761047304",
"telephone_number": "817-250-4280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "KRISTINA",
"middle_name": "LEAH",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-16",
"last_updated": "2022-02-21",
"certification_date": "2022-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN567319",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "811965",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "SP009505",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TX",
"license": "811965",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "316409704",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kng178352@Direct.TexasHealth.org",
"affiliation": "N",
"address_1": "800 5th Ave Ste 500",
"city": "Fort Worth",
"state": "TX",
"country_code": "US",
"postal_code": "761047304",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.