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CHRISTINE ROSEANN IDEMUDIA APRN-CNP
NPI 1366192973
Nurse Practitioner - Family in Keller, TX

Active since March 26, 2022PECOS EnrolledAccepts Medicare Assignment
8739 DAVIS BLVD STE 100, KELLER, TX 76248(817) 476-1226(888) 355-4603 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 5, 2026, Mar 15, 2025, Aug 15, 2023 (3 updates tracked since 2023).

About Christine Roseann Idemudia Aprn-cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHRISTINE ROSEANN IDEMUDIA APRN-CNP (NPI 1366192973) is an individual family provider in Keller, Texas, licensed in New Mexico (67455) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Clovis, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1366192973
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCHRISTINE ROSEANN IDEMUDIACredential: APRN-CNP
Location Address8739 DAVIS BLVD STE 100Keller, TX 76248-0309
Mailing Address8739 Davis Blvd Ste 100Keller, TX 76248-0309 · (817) 476-1226 · Fax (888) 355-4603
Phone(817) 476-1226
Fax(888) 355-4603
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 26, 2022
Last NPPES UpdateAugust 5, 20263 updates tracked since enumeration
NPPES CertifiedAugust 5, 2026
✔ NPI 1366192973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NM · 67455
Also ListedHealth and Wellness CoachTaxonomy 171400000X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 67455 (NM)
8739 DAVIS BLVD STE 100, Keller, TX 76248
Open in Google Maps ↗

Secondary Practice Location 1

Location 1501 Commerce Way Ste 3Clovis, NM 88101-4870 · Phone (575) 693-9811

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare, WellPoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Christine Roseann Idemudia Aprn-cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628433927
PECOS Enrollment IDI20260723005188
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Christine Idemudia reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lakeway Medical Clinic, LLC
182 mi
Family Medicine
1008 RANCH ROAD 620 S
Lakeway, TX 78734
  • Reassigned Medicare billing, Texas enrollment
  • 7 clinicians in this Medicare group
NPI 1265190235 (512) 714-9602

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76248 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JEANINE MARIE TACKLA APRN, MSN, A-GNP-C,
Nurse Practitioner (Gerontology)
8739 DAVIS BLVD STE 100
KELLER, TX 76248
Tarrant County (817) 476-1226

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Christine Idemudia's NPI number?

The NPI number for Christine Idemudia is 1366192973. It was assigned to this individual provider in the NPPES registry on March 26, 2022.

Where is Christine Idemudia located?

Christine Idemudia practices at 8739 Davis Blvd Ste 100, Keller, TX 76248. The listed phone number is (817) 476-1226.

What is Christine Idemudia's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Christine Idemudia enrolled in Medicare?

Yes. Christine Idemudia is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Christine Idemudia's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Christine Idemudia reassigns Medicare benefits to Lakeway Medical Clinic, LLC (Lakeway, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Christine Idemudia's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Christine Idemudia accept?

Health plans from Blue Cross and Blue Shield of Texas, UnitedHealthcare and WellPoint list Christine Idemudia as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Christine Idemudia was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.