Individual provider Active NPI

Mary N Kangethe, NP

  • Primary Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1063186724
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1049284 Issued in TX
Practice address
4700 W Sam Houston Pkwy N Ste 220
Houston, TX 77041-8224
Phone
(713) 402-7824
Fax
(713) 570-0196
NPI assigned
Aug 5, 2021
Last updated
May 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1049284 TX Primary

Addresses

Primary practice location

4700 W Sam Houston Pkwy N Ste 220
Houston, TX 77041-8224

Mailing address

3290 Havenwood Chase LN
Pearland, TX 77584-6106
Phone (832) 798-5304

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
I20230406000895 TX Practitioner - Nurse Practitioner 4880069772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

San Antonio, TX 78257
Phone (210) 617-4706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1049284TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince May 1, 2023 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince May 1, 2023 Accepting new patients

Locations

4700 W Sam Houston Pkwy N
Ste 220
Houston, TX 77041
Phone (713) 402-7824

19500 Ih 10 W
#15030
San Antonio, TX 78257
Phone (210) 617-4607

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: mary.kangethe@wellmed.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1063186724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 HAVENWOOD CHASE LN",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775846106",
            "telephone_number": "832-798-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W SAM HOUSTON PKWY N STE 220",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770418224",
            "telephone_number": "713-402-7824",
            "fax_number": "713-570-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANGETHE",
        "first_name": "MARY",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1049284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.