Individual provider Active NPI

Karen Theriot, NP

  • Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1669760989
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
584753 Issued in TX
Practice address
4046 Dowlen Rd
Beaumont, TX 77706-6849
Phone
(409) 225-5924
Fax
(406) 239-5454
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 584753 TX Primary

Addresses

Primary practice location

4046 Dowlen Rd
Beaumont, TX 77706-6849

Mailing address

4046 Dowlen Rd
Beaumont, TX 77706-6849
Phone (409) 225-5924

Other practice location 1

2955 Harrison St
Ste 307
Beaumont, TX 77702-1154
Phone (409) 899-7113

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
I20110914000406 TX Practitioner - Nurse Practitioner 9234300799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Texas Medical Branch at Galveston, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

4046 Dowlen Rd
Beaumont, TX 77706-6849
Phone (409) 225-5924

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
584753TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Apr 1, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Apr 1, 2022 Accepting new patients
Port Arthur Emergency Physicians Nurse Practitioner Past Accepting new patients

Locations

4046 Dowlen Rd
Beaumont, TX 77706
Phone (409) 225-5924

4938 S Staples St
Ste E8
Corpus Christi, TX 78411
Phone (361) 452-9620

11823 Culebra Rd
Ste 105
San Antonio, TX 78253
Phone (210) 598-1517

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: ktheriot288850@christushealth.direct-ci.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1669760989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 DOWLEN RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777066849",
            "telephone_number": "409-225-5924",
            "fax_number": "406-239-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4046 DOWLEN RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777066849",
            "telephone_number": "409-225-5924",
            "fax_number": "406-239-5454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2955 Harrison St",
            "address_2": "Ste 307",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777021154",
            "country_code": "US",
            "telephone_number": "409-899-7113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THERIOT",
        "first_name": "KAREN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "584753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.