Individual provider Active NPI

Bernadette A Agustin, BSN,RN,CNOR,RNFA

  • Registered Nurse First Assistant
  • Richardson, TX
National Provider Identifier
1225448343
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
618735 Issued in TX
Practice address
3220 Thorne Hill CT
Richardson, TX 75082-3762
Phone
(469) 487-6177
NPI assigned
Apr 28, 2014
Last updated
Apr 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 618735 TX Primary
Registered Nurse First Assistant 163WR0006X 041288193 IL

Addresses

Primary practice location

3220 Thorne Hill CT
Richardson, TX 75082-3762

Mailing address

3220 Thorne Hill CT
Richardson, TX 75082-3762
Phone (469) 487-6177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041288193ILMDRegistered Nurse First Assistant
618735TXMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1225448343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 THORNE HILL CT",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823762",
            "telephone_number": "469-487-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 THORNE HILL CT",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823762",
            "telephone_number": "469-487-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "BERNADETTE",
        "middle_name": "A",
        "credential": "BSN,RN,CNOR,RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "TX",
            "license": "618735",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "IL",
            "license": "041288193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.