Active NPI
Kathryn Irene Kennelly, NP
- Family Nurse Practitioner
- Plano, TX
National Provider Identifier
1013971258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F0804014
- Practice address
- 617 E 16TH St
Plano, TX 75074-5726 - Phone
- (972) 423-8110
- Fax
- (972) 423-1699
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0804014 | TX | Primary |
Addresses
Primary practice location
617 E 16TH St
Plano, TX 75074-5726
Mailing address
617 E 16TH St
Plano, TX 75074-5726
Phone (972) 423-8110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 169741902 | Medicaid | TX |
Other names 1
- Kathryn Irene Cain
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F0804014 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medcare House Calls LLC | Past | Accepting new patients | |
| Allergy Arts LLP | Family | Past | Accepting new patients |
| Ammar Jarrous MD PA | Past | Accepting new patients | |
| Thomas a. Sames, M.D., P.a. | Past | Accepting new patients |
Organizations & group practices 4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393372800000",
"number": "1013971258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 E 16TH ST",
"city": "PLANO",
"state": "TX",
"postal_code": "750745726",
"telephone_number": "972-423-8110",
"fax_number": "972-423-1699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 E 16TH ST",
"city": "PLANO",
"state": "TX",
"postal_code": "750745726",
"telephone_number": "972-423-8110",
"fax_number": "972-423-1699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNELLY",
"first_name": "KATHRYN",
"middle_name": "IRENE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2014-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "F0804014",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "169741902",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHRYN",
"last_name": "CAIN",
"middle_name": "IRENE",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.