Kathleen Devera Tembrock, AC-CPNP, MSN, CCRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1021237 Issued in TX

Practice address

1935 Medical District Dr
Dallas, TX 75235-7701

Phone

(214) 740-6177

NPI assigned

Sep 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kathleen Kaye Devera Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1376191312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-740-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMBROCK",
        "first_name": "KATHLEEN",
        "middle_name": "DEVERA",
        "credential": "AC-CPNP, MSN, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "OR",
            "license": "201709498RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1021237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tembrock@ohsu.edu",
            "affiliation": "N",
            "endpointDescription": "OHSU email",
            "address_1": "3455 SW US Veterans Hospital Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972393076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DEVERA",
            "middle_name": "KAYE",
            "credential": "BSN, CCRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Lynn Telste, D.D.S.
• Amanda Telthorst, RN, CLC
• Kartik Sainag Telukuntla
• Leigh Telzrow
• Natalia Temboni Caraballo, O.D.
• Temk International Inc
• Peyton Elizabeth Tempel
• Tempered Medical Holdings, PLLC
• Rommel Temporal
• Ten 20 Medical Distribution LLC

• Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.