Individual provider Active NPI

Krishawna Mund Thompson, NP-C

  • Family Nurse Practitioner
  • Shepherd, TX
National Provider Identifier
1891133294
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
734317 Issued in TX
Practice address
16 N Liberty
Shepherd, TX 77371-2460
Phone
(936) 628-1694
Fax
(936) 628-3109
NPI assigned
Jun 6, 2013
Last updated
Sep 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 734317 TX Primary

Addresses

Primary practice location

16 N Liberty
Shepherd, TX 77371-2460

Mailing address

16 N Liberty
Shepherd, TX 77371-2460
Phone (936) 628-1694

Other names 1

  • Krishawna Marie Mund Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131016001411 TX Practitioner - Nurse Practitioner 0941440291 Reassigns benefits to 1 organization
I20240212001615 NV Practitioner - Nurse Practitioner 0941440291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12900 Park Plaza Dr
Suite 150
Cerritos, CA 90703-9329

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: kthompson21251@carelonhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1891133294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N LIBERTY",
            "city": "SHEPHERD",
            "state": "TX",
            "postal_code": "773712460",
            "telephone_number": "936-628-1694",
            "fax_number": "936-628-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N LIBERTY",
            "city": "SHEPHERD",
            "state": "TX",
            "postal_code": "773712460",
            "telephone_number": "936-628-1694",
            "fax_number": "936-628-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KRISHAWNA",
        "middle_name": "MUND",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "734317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISHAWNA",
            "last_name": "MUND",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shepherd, TX

Sources for this page

Verify at the official NPI Registry.