Kelley Kennedy Schulze, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

650862 Issued in TX

Practice address

1651 Rock Prairie Rd
#102
College Station, TX 77845-8652

Phone

(979) 693-7400

Fax

(979) 693-7446

NPI assigned

Jul 27, 2009

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 5

Other names 1

• Kelley Jeanne Kennedy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Brazos Valley Community Action Agency, Inc.

  dba HealthPoint

  • Federally Qualified Health Center (FQHC)
  • Bryan, TX
  • NPI 1649265646
  NPD (past)
• Brazos Valley Community Action Agency, Inc.

  dba HealthPoint

  • Obstetrics Physician
  • College Station, TX
  • NPI 1811171580
  NPD (past)

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1063643922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E",
            "address_2": "#100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600",
            "telephone_number": "979-846-1100",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 ROCK PRAIRIE RD",
            "address_2": "#102",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458652",
            "telephone_number": "979-693-7400",
            "fax_number": "979-693-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZE",
        "first_name": "KELLEY",
        "middle_name": "KENNEDY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "650862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CS CLINIC NPI",
            "identifier": "1275726853",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154467801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY NPI",
            "identifier": "1821185299",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRYAN-COLLEGE STATION CLINIC NPI",
            "identifier": "1649265646",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187842301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "KENNEDY",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Douglas Kurt Schreiber II, LMT
• Charles Conrad Schroeppel, O.D.
• Delores Buchanan Schubert, RN
• Jamie Renae Schubert, FNP-C
• Jennifer Lynn Schuckman, DC
• Emily Schumaker, CCC-SLP
• Scott & White Clinic
• Scott & White Clinic (Scott & White Infusion Center)
• Scott & White Clinic
• Scott & White Clinic

• Pediatric Nurse Practitioner in College Station, TX
• Providers in College Station, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.