Kristi B Bagnell

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KRISTI B BAGNELL

Practice address

2304 Judson Rd Ste D
Longview, TX 75605-4675

Phone

(903) 212-6060

NPI assigned

Mar 23, 2018

Organization subpart

No

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

Authorized official

Name

Michael Bagnell

Title

Manager

Phone

(305) 587-9062

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristi Bengtson Bagnell, MD

  • Pediatrics Physician
  • Longview, TX
  • NPI 1841444692
  NPD

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521763200000",
    "number": "1669976528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 JUDSON RD STE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054675",
            "telephone_number": "903-212-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 JUDSON RD STE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054675",
            "telephone_number": "903-212-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTI B BAGNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A",
        "authorized_official_last_name": "BAGNELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-587-9062"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Longview, TX
• Providers in Longview, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.