Individual provider Active NPI

Kirsten Perricone, APRN

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1528678406
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1021328 Issued in TX
Practice address
700 Olympic Plaza Cir Ste 700
Tyler, TX 75701-1954
Phone
(903) 262-3900
Fax
(903) 262-3993
NPI assigned
Aug 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 1021328 TX Primary
Registered Nurse 163W00000X 839693 TX

Addresses

Primary practice location

700 Olympic Plaza Cir Ste 700
Tyler, TX 75701-1954

Mailing address

700 Olympic Plaza Cir Ste 700
Tyler, TX 75701-1954
Phone (903) 262-3900

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
I20221012000419 TX Practitioner - Nurse Practitioner 4486043791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

700 Olympic Plaza Cir
Suite 700
Tyler, TX 75701-1954
Phone (903) 262-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
839693TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Texas a&M University System Health Science Center Multi-Specialty CurrentSince Mar 1, 2025 Accepting new patients
Etmc Physician Group Inc. Multi-Specialty CurrentSince Nov 1, 2025 Accepting new patients
Etmc Physician Group Inc. CurrentSince Nov 1, 2025 Accepting new patients
Jacinto Medical Group P a Multi-Specialty CurrentSince Jul 1, 2022 Accepting new patients

Locations

2800 Garth Rd
Baytown, TX 77521
Phone (281) 425-3800

8447 John Sharp Pkwy
Bryan, TX 77807
Phone (979) 436-0200

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

700 Olympic Plaza Cir
Ste 700
Tyler, TX 75701
Phone (903) 262-3900

Interoperability endpoints

  • Direct secure messaging: kperricone32244@texasamuniversity.gardenplot.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1528678406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 700",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-262-3900",
            "fax_number": "903-262-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 700",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-262-3900",
            "fax_number": "903-262-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRICONE",
        "first_name": "KIRSTEN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1021328",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "839693",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.