Kristen Godett, NURSE PRACTIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1052585 Issued in TX

Practice address

607 Camden St
San Antonio, TX 78215-1610

Phone

(211) 023-3712

Fax

(855) 838-0423

NPI assigned

Feb 26, 2018

Reactivated

Sep 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Agave Functional Medicine Clinic PLLCGroup PAC ID 6800333568, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Blue Agave Functional Medicine Clinic PLLC

  • General Practice Physician
  • New Braunfels, TX
  • NPI 1063191138

  TX

  Medicare reassignment Care Compare group NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1902883739

  TX

  Medicare reassignment NPD
• Barrio Comprehensive Family Health Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1003228750
  NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Marcos, TX
  • NPI 1295601052
  NPD
• Hillside Primary Care PLLC

  • Internal Medicine Physician
  • Live Oak, TX
  • NPI 1205349040

  Internal Medicine

  NPD (past)
• Texas Kids Home Therapy Professional Limited Liability Company

  • Home Health Agency
  • Boerne, TX
  • NPI 1790065845
  NPD (past)

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1861993701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MED CT STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583484",
            "telephone_number": "210-494-4290",
            "fax_number": "210-494-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 CAMDEN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151610",
            "telephone_number": "211-023-3712",
            "fax_number": "855-838-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODETT",
        "first_name": "KRISTEN",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "deactivation_date": "2021-08-28",
        "reactivation_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "1052585",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1052585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gocare Home Health Services LLC
• God and Christ Care
• Diane Marie Goddard, PMHNP
• Traci-Lin Goddin, OD
• Jane Nolasco Godelia, LPC
• Amanda Kim Godfrey, SLPA
• Lauren Godfrey
• Tammy Ann Godfrey, SLP
• Nicole Godines
• Carlos Draeger Godinez Jr., M.D.

• All providers in San Antonio, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.