Active NPI
Kenesha Barnes
- Clinical Medical Laboratory
- Beaumont, TX
National Provider Identifier
1033719059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 45D2181001
- Practice address
- 9615 College St
Building 2 Ste 1
Beaumont, TX 77707 - Phone
- (409) 338-4589
- NPI assigned
- Oct 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 45D2181001 | TX | Primary |
Addresses
Primary practice location
9615 College St
Building 2 Ste 1
Beaumont, TX 77707
Mailing address
9615 College St Ste 1
Beaumont, TX 77707-2604
Phone (409) 338-4589
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
| License | State | Type | Specialty |
|---|---|---|---|
| 45D2181001 | TX | MD | Clinical Medical Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646697600000",
"number": "1033719059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9615 COLLEGE ST STE 1",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777072604",
"telephone_number": "409-338-4589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9615 COLLEGE ST",
"address_2": "BUILDING 2 STE 1",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "77707",
"telephone_number": "409-338-4589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARNES",
"first_name": "KENESHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-28",
"last_updated": "2022-03-08",
"certification_date": "2022-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "TX",
"license": "45D2181001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.