Individual provider Active NPI

Erin Kearney, P.A.-C

  • Medical Physician Assistant
  • Galveston, TX
National Provider Identifier
1598837619
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA05088 Issued in TX
Practice address
3014 Sealy St
#158
Galveston, TX 77550-4218
Phone
(409) 761-6216
Fax
(409) 770-0298
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA05088 TX Primary

Addresses

Primary practice location

3014 Sealy St
#158
Galveston, TX 77550-4218

Mailing address

3014 Sealy St
#158
Galveston, TX 77550-4218
Phone (409) 761-6216

Other identifiers 1

IdentifierTypeStateIssuer
PA05088OtherTXPHYSICIAN ASSISTANT

Other names 1

  • Erin Kearney Conrad Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05088TXMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1598837619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 SEALY ST",
            "address_2": "#158",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775504218",
            "telephone_number": "409-761-6216",
            "fax_number": "409-770-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 SEALY ST",
            "address_2": "#158",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775504218",
            "telephone_number": "409-761-6216",
            "fax_number": "409-770-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "ERIN",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "PA05088",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "CONRAD",
            "middle_name": "KEARNEY",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Galveston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.