Individual provider Active NPI

Kristen Stevenson, DO

  • Family Medicine Physician
  • Keller, TX
National Provider Identifier
1669979365
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S8921 Issued in TX
Practice address
4925 Golden Triangle Boulevard
Suite 311
Keller, TX 76244
Phone
(817) 741-7353
Fax
(817) 741-7501
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X S8921 TX Primary

Addresses

Primary practice location

4925 Golden Triangle Boulevard
Suite 311
Keller, TX 76244

Mailing address

4925 Golden Triangle Boulevard
Suite 311
Keller, TX 76244
Phone (817) 741-7353

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210715002003 TX Practitioner - Family Practice 2062814890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catalyst Physician Group - NTX, PLLCGroup PAC ID 4284074758, 87 clinicians

Practice addresses (Care Compare)

4925 Golden Triangle Blvd
Suite 311
Fort Worth, TX 76244-4493
Phone (817) 741-7353

Hospital & facility affiliations

  • Medical City Alliance Hospital, Fort Worth, TX, CCN 670103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Catalyst Physician Group - NTX, PLLC Family Medicine CurrentSince Apr 6, 2024 Accepting new patients

Locations

469 Westpark Way
Euless, TX 76040
Phone (817) 283-2888

4925 Golden Triangle Blvd
Ste 311
Fort Worth, TX 76244
Phone (817) 404-4811

1610 Commons Cir
Northlake, TX 76226
Phone (940) 725-3400

Interoperability endpoints

  • Direct secure messaging: kristen.stevenson.1@30724.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1669979365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 GOLDEN TRIANGLE BOULEVARD",
            "address_2": "SUITE 311",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-741-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 GOLDEN TRIANGLE BOULEVARD",
            "address_2": "SUITE 311",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-741-7353",
            "fax_number": "817-741-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "KRISTEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S8921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.