NPIMap

Individual provider Active NPI

Kris H Wusterhausen, DO

  • Family Medicine Physician
  • Weatherford, TX
National Provider Identifier
1780681114
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K8703 Issued in TX
Practice address
1517 Texas Drive
Weatherford, TX 76086-6327
Phone
(817) 458-3300
Fax
(817) 458-3370
NPI assigned
Jun 30, 2005
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K8703 TX Primary

Addresses

Primary practice location

1517 Texas Drive
Weatherford, TX 76086-6327

Mailing address

1517 Texas Drive
Weatherford, TX 76086-6327
Phone (817) 458-3300

Other identifiers 3

IdentifierTypeStateIssuer
8H0110OtherBCBS
137469OtherAETNA
144541302MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL kris.wusterhausen.1@9877.direct.athenahealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081215000675 TX Practitioner - Family Practice 0941362610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Parker County Hospital DistrictGroup PAC ID 0840269163, 10 clinicians
West Oak Medical Clinic PAGroup PAC ID 7719078989, 2 clinicians

Practice addresses (Care Compare)

1517 Texas Dr
Weatherford, TX 76086-6327
Phone (817) 458-3342

2066 N Valley Mills Dr
Waco, TX 76710-2561
Phone (254) 339-1310

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Parker County Hospital District CurrentSince Jan 1, 2014 Accepting new patients
Parker County Hospital District CurrentSince Jan 1, 2014 Accepting new patients
West Oak Medical Clinic PA Family Medicine CurrentSince Aug 26, 2012 Accepting new patients
Omni Housecalls LLC Past Accepting new patients
Winnie-Stowell Hospital District Past Accepting new patients
Glen Rose I Enterprises, LLC Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients
700 S Bowie Dr Opco LLC Past Accepting new patients
Summit LTC Weatherford II, LLC Past Accepting new patients
Parker County Hospital District Past Accepting new patients
Fannin County Hospital Authority Past Accepting new patients
Parker County Hospital District Past Accepting new patients
P S Well-Child Clinic Family Medicine Past Accepting new patients

Locations

2066 N Valley Mills Dr
Waco, TX 76710
Phone (254) 741-6952

1517 Texas Dr
Weatherford, TX 76086
Phone (817) 458-3300

1715 Martin Dr
Weatherford, TX 76086
Phone (817) 458-3100

407 W Oak St
West, TX 76691
Phone (254) 826-3721

Interoperability endpoints

  • Direct secure messaging: kris.wusterhausen.1@9877.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hilltop Park Rehabilitation and Healthcare CenterWeatherford, TX, CCN 675988 Skilled nursing facility Adp of the SNF Jan 15, 2015
College Park Rehabilitation and Care CenterWeatherford, TX, CCN 676212 Skilled nursing facility Adp of the SNF Jan 15, 2025
Granbury Care CenterGranbury, TX, CCN 455915 Skilled nursing facility Adp of the SNF Jan 1, 2025
Peach Tree PlaceWeatherford, TX, CCN 676148 Skilled nursing facility Adp of the SNF Apr 13, 2025
Avir at KeenelandWeatherford, TX, CCN 675708 Skilled nursing facility Adp of the SNF Sep 1, 2025

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 10

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1780681114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 TEXAS DRIVE",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866327",
            "telephone_number": "817-458-3300",
            "fax_number": "817-458-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 TEXAS DRIVE",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866327",
            "telephone_number": "817-458-3300",
            "fax_number": "817-458-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUSTERHAUSEN",
        "first_name": "KRIS",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K8703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8H0110",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "137469",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144541302",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kris.wusterhausen.1@9877.direct.athenahealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1517 Texas Drive",
            "city": "Weatherford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760866327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

Verify at the official NPI Registry.