Individual provider Active NPI

McKenna Caldera, FNP

  • Family Nurse Practitioner
  • Stephenville, TX
National Provider Identifier
1487486841
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1171230 Issued in TX
Practice address
135 River North Blvd
Stephenville, TX 76401-1804
Phone
(254) 965-2810
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 1171230 TX Primary

Addresses

Primary practice location

135 River North Blvd
Stephenville, TX 76401-1804

Mailing address

2890 County Road 273
Stephenville, TX 76401-7419
Phone (254) 485-3122

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
I20241030001806 TX Practitioner - Nurse Practitioner 8224561162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

135 River N Blvd
Stephenville, TX 76401-1804
Phone (254) 965-2810

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1171230TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Timbers Health Clinics, Inc. Current Accepting new patients
Cross Timbers Health Clinics, Inc CurrentSince Sep 10, 2024 Accepting new patients
Cross Timbers Health Clinics, Inc CurrentSince Sep 10, 2024 Accepting new patients

Locations

1100 W Reynosa Ave
De Leon, TX 76444
Phone (254) 893-5895

135 River North Blvd
Stephenville, TX 76401
Phone (254) 965-2810

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1487486841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 COUNTY ROAD 273",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764017419",
            "telephone_number": "254-485-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 RIVER NORTH BLVD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764011804",
            "telephone_number": "254-965-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERA",
        "first_name": "MCKENNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1171230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

Verify at the official NPI Registry.