Individual provider Active NPI

Krystil Ravenell, APRN

  • Family Nurse Practitioner
  • Granbury, TX
National Provider Identifier
1245899210
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139660 Issued in TX
Practice address
112 Maverick CT
Granbury, TX 76049-1381
Phone
(888) 731-8994
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139660 TX Primary

Addresses

Primary practice location

112 Maverick CT
Granbury, TX 76049-1381

Mailing address

112 Maverick CT
Granbury, TX 76049-1381
Phone (888) 731-8994

Other practice location 1

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (888) 731-8994

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
I20250131001018 TX Practitioner - Nurse Practitioner 6608305982 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Oct 21, 2024 Accepting new patients
Ut Physicians CurrentSince Oct 21, 2024 Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
#135
Houston, TX 77030

6410 Fannin St
Ste 100
Houston, TX 77030
Phone (713) 500-3261

Interoperability endpoints

  • Direct secure messaging: kravenell12925@direct.uth.org
  • Direct secure messaging: krystil.ravenell.1@27069.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1245899210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MAVERICK CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760491381",
            "telephone_number": "888-731-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MAVERICK CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760491381",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Orange Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328012381",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVENELL",
        "first_name": "KRYSTIL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.