Active NPI
Kadar Julius Vannoy, MD
- Pediatrics Physician
- Humble, TX
National Provider Identifier
1013588995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2021023498
- Practice address
- 20418 US-59
Suite a
Humble, TX 77338 - Phone
- (832) 602-4040
- NPI assigned
- Jul 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2021023498 | MO | Primary |
Addresses
Primary practice location
20418 US-59
Suite a
Humble, TX 77338
Mailing address
20418 US-59
Suite a
Humble, TX 77338
Phone (832) 602-4040
Other practice location 1
1 Childrens Pl Ste 3S34
Saint Louis, MO 63110-1002
Phone (404) 918-5710
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/apl/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021023498 | MO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1013588995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20418 US-59",
"address_2": "SUITE A",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77338",
"telephone_number": "832-602-4040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20418 US-59",
"address_2": "SUITE A",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77338",
"telephone_number": "832-602-4040"
}
],
"practiceLocations": [
{
"address_1": "1 Childrens Pl Ste 3S34",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101002",
"country_code": "US",
"telephone_number": "404-918-5710",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANNOY",
"first_name": "KADAR",
"middle_name": "JULIUS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-01",
"last_updated": "2024-07-11",
"certification_date": "2024-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2021023498",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/apl/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1 Childrens Pl Ste 3S34",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.