Individual provider Active NPI

Katrina L Hallmark, PSYD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1285708420
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31018 Issued in TX
Practice address
16607 Blanco Rd Ste 904
San Antonio, TX 78232-1942
Phone
(786) 837-1366
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5874 FL
Clinical Psychologist 103TC0700X 31018 TX Primary

Addresses

Primary practice location

16607 Blanco Rd Ste 904
San Antonio, TX 78232-1942

Mailing address

13806 Norland St
San Antonio, TX 78232-4920
Phone (786) 837-1366

Other practice location 1

6401 SW 87th Ave
suite 114
Miami, FL 33173-2500
Phone (786) 837-1366

Other practice location 2

113 Pleasant Valley Dr Ste 210
Boerne, TX 78006-5683
Phone (830) 267-4575

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125000775 TX Practitioner - Clinical Psychologist 7911939517 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13333 Blanco Rd
Suite 220
San Antonio, TX 78216-7755
Phone (786) 837-1366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY5874FLMDPsychologist
31018TXMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1285708420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13806 NORLAND ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324920",
            "telephone_number": "786-837-1366",
            "fax_number": "210-468-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16607 BLANCO RD STE 904",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321942",
            "telephone_number": "786-837-1366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 SW 87th Ave",
            "address_2": "suite 114",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331732500",
            "country_code": "US",
            "telephone_number": "786-837-1366",
            "fax_number": "305-246-0829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "113 Pleasant Valley Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Boerne",
            "state": "TX",
            "postal_code": "780065683",
            "country_code": "US",
            "telephone_number": "830-267-4575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALLMARK",
        "first_name": "KATRINA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5874",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.