Individual provider Active NPI

Kimberly Joy Staton, FNP

  • Family Nurse Practitioner
  • Galveston, TX
National Provider Identifier
1023617685
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1017785 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-5303
Phone
(409) 772-1011
NPI assigned
Oct 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1017785 TX
Family Nurse Practitioner 363LF0000X 1017785 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-5303

Mailing address

PO Box 650859 Dept 710
Dallas, TX 75265-4017
Phone (409) 772-0620

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
I20201130001107 TX Practitioner - Nurse Practitioner 5597176347 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

10121 Emmett F Lowry Expy
Texas City, TX 77591-2286
Phone (409) 986-9686

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Nov 16, 2020 Accepting new patients
Emergency Medicine Services of TX, PLLC CurrentSince Aug 1, 2023 Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

2327 E Mulberry St
Angleton, TX 77515
Phone (979) 848-1886

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

6191 E Sam Houston Pkwy N
#B
Houston, TX 77049
Phone (713) 295-5300

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

10121 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-8466

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Interoperability endpoints

  • Direct secure messaging: kstatonrn32522@direct.utmb.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1023617685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859 DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752654017",
            "telephone_number": "409-772-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555303",
            "telephone_number": "409-772-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "KIMBERLY",
        "middle_name": "JOY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1017785",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1017785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.