Individual provider Active NPI

Kimberly Glynn Jones

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1003666934
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1168746 Issued in TX
Practice address
1034 W 42ND St
Houston, TX 77018-4314
Phone
(832) 283-6722
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1168746 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1034 W 42ND St
Houston, TX 77018-4314

Mailing address

1034 W 42ND St
Houston, TX 77018-4314
Phone (832) 283-6722

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
I20240731003319 TX Practitioner - Nurse Practitioner 5799222386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

6410 Fannin St
Suite 350
Houston, TX 77030-3004
Phone (832) 325-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1168746TXMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jul 15, 2024 Accepting new patients
Ut Physicians CurrentSince Jul 15, 2024 Accepting new patients

Locations

6410 Fannin St
Ste 350
Houston, TX 77030
Phone (832) 325-7200

6410 Fannin St
#135
Houston, TX 77030

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1003666934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 W 42ND ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770184314",
            "telephone_number": "832-283-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 W 42ND ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770184314",
            "telephone_number": "832-283-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KIMBERLY",
        "middle_name": "GLYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1168746",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.