Individual provider Active NPI

Kimberly Sue Coyle

  • Family Nurse Practitioner
  • College Station, TX
National Provider Identifier
1043053143
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1166649 Issued in TX
Practice address
13055 FM 2154 Rd
College Station, TX 77845-3907
Phone
(979) 661-6510
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1166649 TX Primary

Addresses

Primary practice location

13055 FM 2154 Rd
College Station, TX 77845-3907

Mailing address

13055 FM 2154 Rd
College Station, TX 77845-3907
Phone (979) 661-6510

Other names 1

  • Kimberly Sue Keahey Former name

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
I20260512003056 TX Practitioner - Nurse Practitioner 8527537273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas a & M University System, HSC, College of Medicine, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Riverview Blvd
Methuen, MA 01844-6026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1166649TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aggieland Urgent Care PLLC PastSince Nov 1, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAFCCD/Endpoint/CAFCCD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1043053143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13055 FM 2154 RD",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778453907",
            "telephone_number": "979-661-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13055 FM 2154 RD",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778453907",
            "telephone_number": "979-661-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1166649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KEAHEY",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.