Kristin Bravenec Jackson, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP130196 Issued in TX

Practice address

100 Medical Dr
Lake Jackson, TX 77566-5674

Phone

(979) 285-1170

NPI assigned

Oct 19, 2015

Last updated

Jan 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristin Bravenec Former name

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Emergency Services Physician Group-Houston PLLCGroup PAC ID 7113258500, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Luke's Health Brazosport Hospital, Lake Jackson, TX, CCN 450072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Emergency Services Physician Group-Houston PLLC

  dba IES Houston

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Community Hospital of Brazosport

  dba Brazosport Memorial Hospital &Brazosport Regional Health System

  • General Acute Care Hospital
  • Lake Jackson, TX
  • NPI 1972581940
  Care Compare affiliation

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1215308143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665674",
            "telephone_number": "979-285-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665674",
            "telephone_number": "979-285-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTIN",
        "middle_name": "BRAVENEC",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP130196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "BRAVENEC",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Intentional Actions a Behavior Analytic Approach LLC (Intentional Actions ABA)
• Iph Health Care Services, Inc. (Iph Home Health)
• Iph Hospice Care Inc
• Stellamaris Irabor, FNP-C
• Iso-3, L.L.C.
• William Jackson Jr., O.D.
• Rakesh Jain, MD
• Saundra L Jain, PSYD, LPC
• Jalopy Shoppe, Inc (Praxair Healthcare Services)
• James D Fuchs, M.D.,P.a

• Nurse Practitioner in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.

Verify at the official NPI Registry.