Individual provider Active NPI

Celeste D Kendrick, FNP

  • Family Nurse Practitioner
  • Greeley, CO
National Provider Identifier
1083813190
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
178633 Issued in CO
Practice address
2928 W 10TH St
Greeley, CO 80634-5426
Phone
(970) 584-2100
Fax
(970) 584-2101
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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 178633 CO Primary

Addresses

Primary practice location

2928 W 10TH St
Greeley, CO 80634-5426

Mailing address

2928 W 10TH St
Greeley, CO 80634-5426
Phone (970) 584-2100

Other practice location 1

2601 54th Ave
Greeley, CO 80634-4520
Phone (970) 330-6339

Other practice location 2

2918 W 10th St
Greeley, CO 80634-5457
Phone (970) 584-2100

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
I20210316000717 TX Practitioner - Nurse Practitioner 7416044789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas a & M University System, HSC, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Primary Healthcare, PLLCGroup PAC ID 1052690591, 3 clinicians

Practice addresses (Care Compare)

3030 N St
Suite 310
Beaumont, TX 77702-1434
Phone (409) 354-7900

Hospital & facility affiliations

  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
  • Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
178633COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Primary Healthcare, PLLC CurrentSince Mar 8, 2021 Accepting new patients
Heritage Family Medicine Past Accepting new patients

Locations

3030 North St
Ste 310
Beaumont, TX 77702
Phone (248) 802-9174

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14577/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 2

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1083813190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345426",
            "telephone_number": "970-584-2100",
            "fax_number": "970-584-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345426",
            "telephone_number": "970-584-2100",
            "fax_number": "970-584-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 54th Ave",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806344520",
            "country_code": "US",
            "telephone_number": "970-330-6339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2918 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806345457",
            "country_code": "US",
            "telephone_number": "970-584-2100",
            "fax_number": "970-584-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "CELESTE",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "178633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.