Kathleen C Baccus, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1005508 Issued in TX

Practice address

4408 6TH St
Lubbock, TX 79416-4732

Phone

(806) 791-0399

Fax

(806) 791-0373

NPI assigned

Jul 14, 2020

Last updated

Sep 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Rehab Consultants PLLC

  dba Comprehensive Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  Family, TX

  Medicare reassignment Care Compare group NPD
• Roger J. Wolcott, M.D., P.a.

  • Physical Medicine & Rehabilitation Physician
  • Lubbock, TX
  • NPI 1356521892
  Medicare reassignment NPD

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1033727219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4408 6TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794164732",
            "telephone_number": "806-791-0399",
            "fax_number": "806-791-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCUS",
        "first_name": "KATHLEEN",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1005508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1F5915",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark Azubuike, MD MPH
• Steve Azzinaro, ASCP
• Eric Babb
• Franklyn Cottam Babb, MD
• Jesus Alonso Baca Soto, M.D.
• Bachar Al Alami (All About Kids)
• Amanda Janine Backlund, M.D.
• Ian Bacon
• Saly Badri
• Faidah O Badru, MD

• Family Nurse Practitioner in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.