Individual provider Active NPI

Mari Van Der Walt, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Webster, TX
National Provider Identifier
1932075504
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1212076 Issued in TX
Practice address
200 Blossom St
Webster, TX 77598-4204
Phone
(832) 632-6500
NPI assigned
Oct 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1212076 TX Primary

Addresses

Primary practice location

200 Blossom St
Webster, TX 77598-4204

Mailing address

18333 Egret Bay Blvd Ste 140
Houston, TX 77058-3239
Phone (281) 332-3001

Other practice location 1

1302 W Forest Dr
Houston, TX 77043-4524
Phone (816) 803-1910

Other practice location 2

18333 Egret Bay Blvd Ste 140
Houston, TX 77058-3239
Phone (281) 332-3001

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260623001561 TX Practitioner - Nurse Practitioner 0941773857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
XpertmdGroup PAC ID 5193092393, 39 clinicians

Practice addresses (Care Compare)

200 Blossom St
Webster, TX 77598-4204
Phone (281) 332-3001

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1212076TXMDPediatric Physical Therapist

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1760313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1932075504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18333 EGRET BAY BLVD STE 140",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583239",
            "telephone_number": "281-332-3001",
            "fax_number": "281-332-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BLOSSOM ST",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984204",
            "telephone_number": "832-632-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 W Forest Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770434524",
            "country_code": "US",
            "telephone_number": "816-803-1910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18333 Egret Bay Blvd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770583239",
            "country_code": "US",
            "telephone_number": "281-332-3001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DER WALT",
        "first_name": "MARI",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-13",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1212076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.