Individual provider Active NPI

Erika Nicole Kelso, F.N.P.-C.

  • Family Nurse Practitioner
  • Boerne, TX
National Provider Identifier
1396289930
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132477 Issued in TX
Practice address
120 Old San Antonio Rd
Boerne, TX 78006-3413
Phone
(800) 337-6663
NPI assigned
Dec 16, 2016
Last updated
Feb 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP132477 TX Primary

Addresses

Primary practice location

120 Old San Antonio Rd
Boerne, TX 78006-3413

Mailing address

120 Old San Antonio Rd
Boerne, TX 78006-3413
Phone (800) 337-6663

Other practice location 1

1584 E. Common St.
New Braunfels, TX 78130
Phone (800) 337-6663

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
I20170213001336 TX Practitioner - Nurse Practitioner 1658654983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John M Tieman MD PAGroup PAC ID 8224011499, 2 clinicians

Practice addresses (Care Compare)

1584 E Common St
New Braunfels, TX 78130-3113
Phone (830) 609-4700

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132477TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John M. Tieman, MD PA CurrentSince Nov 7, 2023 Accepting new patients
Neil F Haddock MD PA PastSince Sep 22, 2021 Accepting new patients
Sandra Dean Shriner MD PLLC Past Accepting new patients

Locations

1584 E Common St
New Braunfels, TX 78130
Phone (830) 609-4700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1396289930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OLD SAN ANTONIO RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063413",
            "telephone_number": "800-337-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OLD SAN ANTONIO RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063413",
            "telephone_number": "800-337-6663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1584 E. Common St.",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "78130",
            "country_code": "US",
            "telephone_number": "800-337-6663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSO",
        "first_name": "ERIKA",
        "middle_name": "NICOLE",
        "credential": "F.N.P.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-16",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.