Individual provider Active NPI

Kevin Patrick Smith, RN

  • Acute Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1083189864
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP139324 Issued in TX
Practice address
6565 Fannin St Ste B452
Houston, TX 77030
Phone
(713) 441-3620
NPI assigned
Oct 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 830503 TX
Acute Care Nurse Practitioner 363LA2100X AP139324 TX Primary

Addresses

Primary practice location

6565 Fannin St Ste B452
Houston, TX 77030

Mailing address

6565 Fannin St Ste B452
Houston, TX 77030-2703
Phone (713) 441-3620

Other practice location 1

6565 Fannin St
Houston, TX 77030-2703
Phone (832) 729-3848

Other practice location 2

6565 Fannin St
Houston, TX 77030-2703
Phone (832) 729-3848

Other identifiers 1

IdentifierTypeStateIssuer
392339301MedicaidTX

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
I20181213001655 TX Practitioner - Nurse Practitioner 2860737236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians

Practice addresses (Care Compare)

6445 Main St
Suite 2500
Houston, TX 77030-1502
Phone (713) 441-3150

6565 Fannin St
Houston, TX 77030-2703

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
830503TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Oct 28, 2018 Accepting new patients
TMH Physician Associates PLLC CurrentSince Oct 28, 2018 Accepting new patients

Locations

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

6565 Fannin St
Ste B452
Houston, TX 77030
Phone (713) 441-3620

6550 Fannin St
Ste 447
Houston, TX 77030
Phone (713) 441-0633

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1083189864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FANNIN ST STE B452",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302703",
            "telephone_number": "713-441-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 FANNIN ST STE B452",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-441-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302703",
            "country_code": "US",
            "telephone_number": "832-729-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302703",
            "country_code": "US",
            "telephone_number": "832-729-3848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "830503",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP139324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "392339301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.