Individual provider Active NPI

Bernadette King, APN

  • Women's Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1417905282
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP106444 Issued in TX
Practice address
6441 High Star
Houston, TX 77074
Phone
(713) 779-6400
Fax
(713) 523-4897
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP106444 TX Primary

Addresses

Primary practice location

6441 High Star
Houston, TX 77074

Mailing address

PO Box 66308
Houston, TX 77266-6308
Phone (713) 830-3060

Other practice location 1

1905 Jacquelyn Dr
Houston, TX 77055-2502
Phone (713) 462-6565

Other identifiers 1

IdentifierTypeStateIssuer
155000601MedicaidTX

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
I20151109000758 TX Practitioner - Nurse Practitioner 4385862796 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP106444TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Branch Community Health Center Current Accepting new patients
Spring Branch Community Health Center CurrentSince Oct 1, 2023 Accepting new patients
Spring Branch Community Health Center CurrentSince Oct 1, 2023 Accepting new patients
Spring Branch Community Health Center Past Accepting new patients

Locations

1615 Hillendahl Blvd
Ste 100
Houston, TX 77055
Phone 7134626565125

5502 1st St
Katy, TX 77493
Phone 7134626565127

Organizations & group practices 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1417905282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "713-830-3060",
            "fax_number": "713-523-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6441 HIGH STAR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77074",
            "telephone_number": "713-779-6400",
            "fax_number": "713-523-4897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1905 Jacquelyn Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770552502",
            "country_code": "US",
            "telephone_number": "713-462-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "BERNADETTE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "AP106444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155000601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.