Individual provider Active NPI

Kristen H Jardine, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1740514595
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09699 Issued in TX
Practice address
1100 Wilford Hall Loop
San Antonio, TX 78236-5638
Phone
(210) 029-2741
NPI assigned
Sep 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09699 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop
San Antonio, TX 78236-5638

Mailing address

1100 Wilford Hall Loop
San Antonio, TX 78236-5638

Other identifiers 1

IdentifierTypeStateIssuer
110194031AMedicaidMA

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
I20160506000110 TX Practitioner - Physician Assistant 7618017112 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 E Sonterra Blvd
San Antonio, TX 78258-3982
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA09699TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Texas PLLC CurrentSince Oct 16, 2025 Accepting new patients
Minuteclinic Diagnostic of Texas PLLC Physician Assistant Current Accepting new patients
Minuteclinic Telehealth Services of Texas Association CurrentSince Oct 16, 2025 Accepting new patients
Minuteclinic Primary Care Texas PLLC Physician Assistant CurrentSince Oct 16, 2025 Accepting new patients
Chima Ohaegbulam, MD PC Past Accepting new patients

Locations

1540 E Main St
Allen, TX 75002
Phone (214) 383-9765

5526 S Congress Ave
Austin, TX 78745
Phone (512) 462-3820

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

11661 Preston Rd
Ste 218
Dallas, TX 75230
Phone (214) 363-1571

1003 Richmond Ave
Houston, TX 77006
Phone (713) 807-8491

3103 Fry Rd
Katy, TX 77449
Phone (281) 646-2964

5002 W Main St
League City, TX 77573
Phone (281) 557-4374

1413 Oates Dr
Mesquite, TX 75150
Phone (972) 613-7001

9522 Broadway St
Pearland, TX 77584
Phone (713) 436-8151

1855 Gattis School Rd
Round Rock, TX 78664
Phone (512) 238-6268

1301 N Saginaw Blvd
Saginaw, TX 76179
Phone (817) 676-4362

5301 Alamo Pkwy
San Antonio, TX 78253
Phone (210) 688-9311

120 E Sonterra Blvd
San Antonio, TX 78258
Phone 2104049006 ext. 76875

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18109/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1740514595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-029-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "KRISTEN",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110194031A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.