Individual provider Active NPI

Kim-Marie Troutman, NP

  • Adult Health Nurse Practitioner
  • Jersey Village, TX
National Provider Identifier
1255328241
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
652747 Issued in TX
Practice address
17376 Northwest Fwy
Jersey Village, TX 77040-1114
Phone
(713) 466-0197
NPI assigned
Oct 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 652747 TX Primary

Addresses

Primary practice location

17376 Northwest Fwy
Jersey Village, TX 77040-1114

Mailing address

17376 Northwest Fwy
Jersey Village, TX 77040-1114
Phone (713) 466-0197

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
I20160607001402 TX Order and Referring Only - Nurse Practitioner 6002870078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
652747TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ep Descant II Mdpa Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3423/brand/1/csg/22/fhir/r4

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1255328241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17376 NORTHWEST FWY",
            "city": "JERSEY VILLAGE",
            "state": "TX",
            "postal_code": "770401114",
            "telephone_number": "713-466-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17376 NORTHWEST FWY",
            "city": "JERSEY VILLAGE",
            "state": "TX",
            "postal_code": "770401114",
            "telephone_number": "713-466-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUTMAN",
        "first_name": "KIM-MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "652747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey Village, TX

Sources for this page

Verify at the official NPI Registry.