Kellie Marie Reardon, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

516912 Issued in TX

Practice address

1301 Wonder World Dr
San Marcos, TX 78666-7533

Phone

(512) 753-3796

NPI assigned

Oct 31, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lone Star Emergency Associates LLCGroup PAC ID 7113054446, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.09 of 100Reported as group

Quality

89.89

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.72 of 100Reported as group

Quality

91.03

Improvement activities

40

Cost

86.6

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 27)

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.

• Lone Star Emergency Associates LLC

  • Emergency Medicine Physician
  • Victoria, TX
  • NPI 1457709040
  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019

  Nurse Practitioner

  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• Laredo Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Laredo, TX
  • NPI 1144254327

  Nurse Practitioner

  Medicare reassignment NPD
• Maverick Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Eagle Pass, TX
  • NPI 1306806781

  Nurse Practitioner

  Medicare reassignment NPD
• Memorial Hermann Hospital Based Physician Group

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1295363497
  Medicare reassignment NPD
• Oleander Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Victoria, TX
  • NPI 1346515103

  Nurse Practitioner

  Medicare reassignment NPD
• Ucp Physicians of Central Texas, PLLC

  • Urgent Care Clinic/Center
  • Georgetown, TX
  • NPI 1922289412
  Medicare reassignment NPD
• Victoria Emergency Associates LLC

  • Emergency Medicine Physician
  • Victoria, TX
  • NPI 1407917164
  Medicare reassignment NPD
• Victoria Emergency Partners LLC

  • Emergency Medicine Physician
  • Gonzales, TX
  • NPI 1164770996
  Medicare reassignment NPD
• Ucp Physicians of Central Texas, PLLC

  • Urgent Care Clinic/Center
  • Austin, TX
  • NPI 1154472967
  NPD

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1487645404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 COUNTY ROAD 419",
            "city": "YOAKUM",
            "state": "TX",
            "postal_code": "779957049",
            "telephone_number": "361-741-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WONDER WORLD DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667533",
            "telephone_number": "512-753-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "KELLIE",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "516912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142619904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89N666",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn F Raska, SLP
• Mayuri Rataul
• Ray Family Therapy, PLLC
• Jacqueline Ray, LVN
• RB Chiro, Inc.
• Robert Record, PHARMD
• Rachel Alison Reed-Cox, HIS
• Brittany Reel, MSN, APRN, FNP-C
• Charles Nelson Reeves, D.D.S.
• Regent Care San Marcos B-3, Limited Partnership

• Nurse Practitioner in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.