Individual provider Active NPI

Kimberly Kay Raglin, LVN

  • Licensed Vocational Nurse
  • Van, TX
National Provider Identifier
1023515608
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
327746 Issued in TX
Practice address
704 E Pennsylvania Ave
Van, TX 75790-2966
Phone
(903) 368-0935
NPI assigned
Apr 10, 2018
Last updated
Apr 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 327746 TX Primary

Addresses

Primary practice location

704 E Pennsylvania Ave
Van, TX 75790-2966

Mailing address

704 E Pennsylvania Ave
Van, TX 75790-2966
Phone (903) 368-0935

Other names 1

  • Mrs. Kimberly Kay Raglin Other name

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

State licenses

LicenseStateTypeSpecialty
327746TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1023515608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 E PENNSYLVANIA AVE",
            "city": "VAN",
            "state": "TX",
            "postal_code": "757902966",
            "telephone_number": "903-368-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 E PENNSYLVANIA AVE",
            "city": "VAN",
            "state": "TX",
            "postal_code": "757902966",
            "telephone_number": "903-368-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGLIN",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "327746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "RAGLIN",
            "middle_name": "KAY",
            "prefix": "MRS.",
            "credential": "BRUMFIELD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Van, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.