Individual provider Active NPI

Kriss E Myers, M.D.

  • Family Medicine Physician
  • Azle, TX
National Provider Identifier
1902876972
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H3919 Issued in TX
Practice address
141 Industrial Ave
Azle, TX 76020-2901
Phone
(817) 444-3231
Fax
(817) 444-3234
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H3919 TX Primary

Addresses

Primary practice location

141 Industrial Ave
Azle, TX 76020-2901

Mailing address

141 Industrial Ave
Azle, TX 76020-2901
Phone (817) 444-3231

Other identifiers 2

IdentifierTypeStateIssuer
138789614MedicaidTX
138789603MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Sep 20, 2024 through Sep 20, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1902876972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 INDUSTRIAL AVE",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760202901",
            "telephone_number": "817-444-3231",
            "fax_number": "817-444-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 INDUSTRIAL AVE",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760202901",
            "telephone_number": "817-444-3231",
            "fax_number": "817-444-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KRISS",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H3919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138789614",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138789603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Azle, TX

Sources for this page

Verify at the official NPI Registry.