Individual provider Active NPI

Katherine Anna Nack, APRN

  • Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1356940837
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
899820 Issued in TX
Practice address
6100 Harris Pkwy Ste 285
Fort Worth, TX 76132-4127
Phone
(817) 263-5864
Fax
(817) 263-3791
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 899820 TX Primary
Critical Care Medicine Nurse Practitioner 363LC0200X 899820 TX

Addresses

Primary practice location

6100 Harris Pkwy Ste 285
Fort Worth, TX 76132-4127

Mailing address

601 Omega Dr Ste 208
Arlington, TX 76014-2075
Phone (817) 465-5881

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
I20210223000640 TX Practitioner - Nurse Practitioner 8527473669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone (817) 335-5288

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.25 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
899820TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Pulmonary & Critical Care Consultants, PA CurrentSince Feb 1, 2021 Accepting new patients
Tarrant Pulmonary Associates LLC CurrentSince Nov 1, 2022 Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA PastSince Feb 1, 2021 Accepting new patients

Locations

601 Omega Dr
Ste 208
Arlington, TX 76014
Phone (817) 465-5881

1201 Fairmount Ave
Fort Worth, TX 76104
Phone (817) 335-5288

6100 Harris Pkwy
Ste 285
Fort Worth, TX 76132
Phone (817) 263-5864

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHHJCD
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72070

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1356940837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OMEGA DR STE 208",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142075",
            "telephone_number": "817-465-5881",
            "fax_number": "817-465-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 HARRIS PKWY STE 285",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324127",
            "telephone_number": "817-263-5864",
            "fax_number": "817-263-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACK",
        "first_name": "KATHERINE",
        "middle_name": "ANNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "899820",
            "primary": true
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "TX",
            "license": "899820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.