Individual provider Active NPI

Kristen Koontz, FNP-C

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1790412864
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11030906 Issued in FL
Practice address
8825 Bee Caves Rd
Austin, TX 78746-4720
Phone
(512) 328-3376
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APRN11030906 FL Primary
Family Nurse Practitioner 363LF0000X 1089250 TX

Addresses

Primary practice location

8825 Bee Caves Rd
Austin, TX 78746-4720

Mailing address

809 S Lamar Blvd Apt 147
Austin, TX 78704-1562
Phone (772) 532-6185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240222003766 FL Practitioner - Nurse Practitioner 4486098910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divani Dermatology LLCGroup PAC ID 2961733803, 13 clinicians

Practice addresses (Care Compare)

8745 N US Hwy 1
Sebastian, FL 32958-7524
Phone (772) 217-5362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1089250TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divani Dermatology LLC CurrentSince Feb 1, 2024 Accepting new patients
Westlake Dermatology PA PastSince Aug 14, 2022 Accepting new patients

Locations

311 Barefoot Blvd
Ste 1
Barefoot Bay, FL 32976
Phone (772) 217-5362

2571 W Eau Gallie Blvd
Ste 2
Melbourne, FL 32935
Phone (321) 777-9091

8745 N US Highway 1
Sebastian, FL 32958
Phone (772) 217-5362

4800 20th St
Vero Beach, FL 32966
Phone (772) 217-5362

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1790412864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 S LAMAR BLVD APT 147",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787041562",
            "telephone_number": "772-532-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 BEE CAVES RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787464720",
            "telephone_number": "512-328-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "KRISTEN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11030906",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1089250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.