Individual provider Active NPI

Christine Liza Zepeda

  • Nurse Practitioner
  • Keller, TX
National Provider Identifier
1477325686
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1130028 Issued in TX
Practice address
423 Keller Pkwy Ste B
Keller, TX 76248-2322
Phone
(682) 788-0340
NPI assigned
Oct 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1130028 TX
Nurse Practitioner 363L00000X 1130028 TX Primary

Addresses

Primary practice location

423 Keller Pkwy Ste B
Keller, TX 76248-2322

Mailing address

423 Keller Pkwy Ste B
Keller, TX 76248-2322
Phone (682) 788-0340

Other practice location 1

4500 Mercantile Plaza Dr Ste 204
Fort Worth, TX 76137-4214
Phone (682) 788-0340

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
I20250904001719 TX Practitioner - Nurse Practitioner 1658873203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

423 Keller Pkwy
Suite B
Keller, TX 76248-2322

4500 Mercantile Plaza Dr
Suite 204
Fort Worth, TX 76137-4228

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1130028TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitale Wellness Group, LLC Nurse Practitioner CurrentSince Jul 22, 2025 Accepting new patients

Locations

423 Keller Pkwy
Ste B
Keller, TX 76248
Phone (682) 788-0340

Interoperability endpoints

  • Direct secure messaging: christine.zepeda@160177656168452.direct.elationemr.com

Organizations & group practices 1

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": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1477325686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 KELLER PKWY STE B",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482322",
            "telephone_number": "682-788-0340",
            "fax_number": "817-612-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 KELLER PKWY STE B",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482322",
            "telephone_number": "682-788-0340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Mercantile Plaza Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761374214",
            "country_code": "US",
            "telephone_number": "682-788-0340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEPEDA",
        "first_name": "CHRISTINE",
        "middle_name": "LIZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1130028",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1130028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.