Individual provider Active NPI

Kerri Lee Truelock, MD

  • Gynecology Physician
  • Kerrville, TX
National Provider Identifier
1750344883
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
M0994 Issued in TX
Practice address
176 Fairway Dr
Kerrville, TX 78028-6437
Phone
(830) 792-0805
Fax
(830) 792-0833
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M0994 TX
Gynecology Physician 207VG0400X M0994 TX Primary

Addresses

Primary practice location

176 Fairway Dr
Kerrville, TX 78028-6437

Mailing address

176 Fairway Dr
Kerrville, TX 78028-6437
Phone (830) 792-0805

Other identifiers 2

IdentifierTypeStateIssuer
8BB240OtherTXBCBS OF TEXAS INDIVIDUAL #
173479002MedicaidTX

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
I20050624000485 TX Practitioner - Obstetrics/Gynecology 4587609060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Gynecology PAGroup PAC ID 2062582638, 3 clinicians

Practice addresses (Care Compare)

176 Fairway Dr
Kerrville, TX 78028-6437
Phone (830) 792-0805

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.54 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0994TXMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Gynecology PA Obstetrics & Gynecology CurrentSince Apr 1, 2008 Accepting new patients
Kerr County OB/GYN Associates, P.a. Obstetrics & Gynecology PastSince Nov 8, 2009 Accepting new patients
Peterson Medical Associates Obstetrics & Gynecology Past Accepting new patients

Locations

218 Sidney Baker St
Kerrville, TX 78028
Phone (830) 257-2070

176 Fairway Dr
Kerrville, TX 78028
Phone (830) 792-0805

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBIEAA

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.

Hospital & facility affiliations 2

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1750344883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 FAIRWAY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286437",
            "telephone_number": "830-792-0805",
            "fax_number": "830-792-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 FAIRWAY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286437",
            "telephone_number": "830-792-0805",
            "fax_number": "830-792-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUELOCK",
        "first_name": "KERRI",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "M0994",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "M0994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS INDIVIDUAL #",
            "identifier": "8BB240",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173479002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

Verify at the official NPI Registry.