Katheren Baccus, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

558304 Issued in TX

Practice address

1317 N Hillcrest Dr
Sulphur Springs, TX 75482-2091

Phone

(903) 438-1110

Fax

(903) 438-1107

NPI assigned

Nov 27, 2007

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1083896567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 N HILLCREST DR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822091",
            "telephone_number": "903-438-1110",
            "fax_number": "903-438-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N HILLCREST DR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822091",
            "telephone_number": "903-438-1110",
            "fax_number": "903-438-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCUS",
        "first_name": "KATHEREN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "558304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198135905",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "752950731",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198135904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asf Group Inc
• Pamela Ash, LPC
• Karen Kim Assunto, RD LD
• Atlanta Pharmacy Inc
• Azle Pharmacy LLC
• Morresa Maelyn Bain, FNP-C
• Mary K Ballard
• Sherri Stone Barclay, M.D.
• Greg Barrett, P.A.
• Kacey Batterton, LPC

• Pediatric Nurse Practitioner in Sulphur Springs, TX
• Providers in Sulphur Springs, 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 Jan 23, 2017; 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.