Individual provider Active NPI

Kristen Katherine Ude, D.C.

  • Nutrition Chiropractor
  • Austin, TX
National Provider Identifier
1720087331
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
10555 Issued in TX
Practice address
1600 W 38TH St
Suite 412
Austin, TX 78731-6400
Phone
(512) 970-8883
Fax
(512) 451-8686
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 10555 TX Primary

Addresses

Primary practice location

1600 W 38TH St
Suite 412
Austin, TX 78731-6400

Mailing address

13021 Legendary Dr
Apt. 1318
Austin, TX 78727-3934
Phone (512) 970-8883

Other identifiers 1

IdentifierTypeStateIssuer
8AA820OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000516 TX Practitioner - Chiropractic 3870687239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13805 Ann PL
Austin, TX 78728-7702
Phone (512) 970-8883

1600 W 38TH St
Suite 412
Austin, TX 78731-6407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10555TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Chiropractic Wellness, PLLC Nutrition CurrentSince May 1, 2007 Accepting new patients

Locations

13805 Ann Pl
Austin, TX 78728
Phone (512) 761-5627

1600 W 38th St
Ste 412
Austin, TX 78731
Phone (512) 451-8682

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.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1720087331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13021 LEGENDARY DR",
            "address_2": "APT. 1318",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787273934",
            "telephone_number": "512-970-8883",
            "fax_number": "512-451-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 412",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-970-8883",
            "fax_number": "512-451-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDE",
        "first_name": "KRISTEN",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "TX",
            "license": "10555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AA820",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.