Krystal Monique Bagley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1020154 Issued in TX

Practice address

1500 Cooper St
Fort Worth, TX 76104-2710

Phone

(682) 885-1116

Fax

(682) 885-3477

NPI assigned

Nov 20, 2020

Last updated

Nov 17, 2023By the provider in NPPES

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbagley207439@cookchildrens.direct-ci.com

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.

• Cook Children's Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD
• Cook Children's Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD
• Cook Children's Medical Center

  dba Cook Children's Behavioral Health

  • Clinical Child & Adolescent Psychologist
  • Fort Worth, TX
  • NPI 1942509963
  NPD (past)
• Hurst Total Care PA

  • Family Medicine Physician
  • Hurst, TX
  • NPI 1447619549
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1871196725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042710",
            "telephone_number": "682-885-1116",
            "fax_number": "682-885-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "KRYSTAL",
        "middle_name": "MONIQUE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1020154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbagley207439@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1500 Cooper St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Badillo, PA-C
• Morolake Badom
• Donald Baer, LPC, LMFT, LPA
• Alexandru C. Bageac, M.D.
• Behzad Baghai, D.D.S.
• Hossein Bagshahi, M.D.
• Jennifer Renee Bagwell Smith, CRNA
• Hallie Bagwell, LPC ASSOCIATE
• Kelsey Bagwell, PT, DPT
• Parham Bahador, MD

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.