Individual provider Active NPI

Kimberly Ann Justice, APRN, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1417574278
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1033630 Issued in TX
Practice address
1915 N Frazier St Ste 102-F10
Conroe, TX 77301-1239
Phone
(806) 591-4117
Fax
(806) 214-3417
NPI assigned
Jun 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1033630 TX Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN-80801 NM
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 60947 NM

Addresses

Primary practice location

1915 N Frazier St Ste 102-F10
Conroe, TX 77301-1239

Mailing address

1915 N Frazier St Ste 102-F10
Conroe, TX 77301-1239
Phone (806) 591-4117

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
I20240829001265 TX Practitioner - Nurse Practitioner 5890234272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

2021 Guadalupe St
Suite 260
Austin, TX 78705-5654
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN-80801NMMDPsychiatric/Mental Health Registered Nurse
60947NMMDPsychiatric/Mental Health Nurse Practitioner
1033630TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Warrior Wellness, PLLC Psychiatric/Mental Health Current Accepting new patients
Sondermind Provider Network LLC Psychiatric/Mental Health CurrentSince Aug 1, 2024 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Aug 9, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

6900 W Interstate 40
Ste 180
Amarillo, TX 79106
Phone (806) 367-8480

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

1915 N Frazier St
Ste 102F10
Conroe, TX 77301
Phone (806) 591-4117

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

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.

NPI Registry JSON

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1417574278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 N FRAZIER ST STE 102-F10",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011239",
            "telephone_number": "806-591-4117",
            "fax_number": "806-214-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 N FRAZIER ST STE 102-F10",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011239",
            "telephone_number": "806-591-4117",
            "fax_number": "806-214-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN, MSN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-28",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1033630",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NM",
            "license": "RN-80801",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "60947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.