Organization Active NPI

North Texas Nutrition & Wellness

  • Nurse Practitioner
  • Gainesville, TX
National Provider Identifier
1083424295
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
NORTH TEXAS NUTRITION & WELLNESS
Practice address
903 E Broadway St
Gainesville, TX 76240-4235
Phone
(940) 336-4584
NPI assigned
Jan 9, 2025
Organization subpart
Yes
Parent organization
KACYE M VANN NURSE PRACTITIONERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Kacye Michelle Vann, FNP-CNPI 1689279374
Title
Owner/Provider
Phone
(940) 736-5317

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

903 E Broadway St
Gainesville, TX 76240-4235

Mailing address

PO Box 308
Valley View, TX 76272-0308
Phone (940) 736-5317

Other practice location 1

1030 E Lone Oak Rd
Valley View, TX 76272-7303
Phone (940) 736-5317

Other identifiers 2

IdentifierTypeStateIssuer
1689279374OtherCOMMERCIAL INSURANCE
1689279374MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250310003149 TX Part B Supplier - Clinic/Group Practice 6406377134 Receives reassigned benefits from 1 practitioner
Practice locations: Gainesville, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2225517North Texas Nutrition & Wellness903 East Broadway, Gainesville, TX 76240Certificate of waiverMay 20, 2027

National Provider Directory

National Provider Directory
Part of
Kacye M Vann Nurse Practitioner

Locations

903 E Broadway St
Gainesville, TX 76240
Phone (940) 336-4584

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1083424295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "VALLEY VIEW",
            "state": "TX",
            "postal_code": "762720308",
            "telephone_number": "940-736-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 E BROADWAY ST",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762404235",
            "telephone_number": "940-336-4584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 E Lone Oak Rd",
            "address_purpose": "LOCATION",
            "city": "Valley View",
            "state": "TX",
            "postal_code": "762727303",
            "country_code": "US",
            "telephone_number": "940-736-5317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH TEXAS NUTRITION & WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KACYE M VANN NURSE PRACTITIONER",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "VANN",
        "authorized_official_first_name": "KACYE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "940-736-5317",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "1689279374",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689279374",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.