Kristina Mata, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP127389 Issued in TX

Practice address

9329 State Hwy 75 S.
New Waverly, TX 77358

Phone

(936) 284-2055

NPI assigned

Oct 6, 2015

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1508236241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 LONG HORN LOOP",
            "city": "NEW WAVERLY",
            "state": "TX",
            "postal_code": "773583735",
            "telephone_number": "936-284-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9329 STATE HWY 75 S.",
            "city": "NEW WAVERLY",
            "state": "TX",
            "postal_code": "77358",
            "telephone_number": "936-284-2055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1032 S Ww White Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782202531",
            "country_code": "US",
            "telephone_number": "210-447-3033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATA",
        "first_name": "KRISTINA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-06",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innerflow Family Wellness, LLC
• Knewman Holdings, LLC
• Macks Home Care LLC
• Valerie Marriner
• Lewanda Martin, LVN
• Kelsey Lynn Mature
• Marianito Militante Militante
• Taryn Leigh Moore, ATC, LAT
• New Waverly Isd
• New Waverly Wellness Clinic

• Family Nurse Practitioner in New Waverly, TX
• Providers in New Waverly, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.