Kristi Bengtson Bagnell, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

N6155 Issued in TX

Practice address

2304 Judson Rd Ste D
Longview, TX 75605-4675

Phone

(903) 212-6060

NPI assigned

Nov 6, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kristi B Bagnell

  • Pediatrics Physician
  • Longview, TX
  • NPI 1669976528
  NPD

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841444692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 JUDSON RD STE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054675",
            "telephone_number": "903-212-6060",
            "fax_number": "903-212-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 JUDSON RD STE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054675",
            "telephone_number": "903-212-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNELL",
        "first_name": "KRISTI",
        "middle_name": "BENGTSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N6155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chamnie Burton Ayres, LP
• Ibraheem Azhar
• Christopher Badami
• Pedro Angel Baez, D.M.D.
• Laureen Furey Bagley, HEALTH COACH
• Baher Elhalwagi, MD, PA
• Latonya Bailey
• Meagan Mishay Bailey, RRT
• Sharita Bailey
• Baker Chiropractic, PA

• Pediatrics Physician in Longview, TX
• Providers in Longview, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.