Jennifer Kent Autry, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP121046 Issued in TX

Practice address

7777 Forest LN Ste C833
Dallas, TX 75230-2591

Phone

(972) 566-4591

Fax

(972) 566-6679

NPI assigned

Oct 21, 2011

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• SRP Behavioral Hospital of Fort Worth LLC

  • Psychiatric Hospital
  • Fort Worth, TX
  • NPI 1447672910
  NPD (past)

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1326323353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HOWARD RD",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760887180",
            "telephone_number": "940-445-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C833",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302591",
            "telephone_number": "972-566-4591",
            "fax_number": "972-566-6679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Howard Rd",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760887180",
            "country_code": "US",
            "telephone_number": "940-255-0839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUTRY",
        "first_name": "JENNIFER",
        "middle_name": "KENT",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP121046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "AP121046",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "868N64",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288504801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autism Treatment Center Rehabilitation Agency
• Autistic Treatment Center, Inc.
• Autistic Treatment Center, Inc.
• Autistic Treatment Center, Inc.
• Ezell S Autrey, MD
• Nikia a Autry
• Autumn E Stoos, DO, PLLC
• Autumn Haven Residential Facility
• Autumn Journey Hospice, Inc.
• Auveta DME LLC

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.