Individual provider Active NPI

Kelley Renee Truss, AG-ACNP

  • Acute Care Nurse Practitioner
  • Victoria, TX
National Provider Identifier
1093319774
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1020314 Issued in TX
Practice address
2701 Hospital Dr
Victoria, TX 77901-5749
Phone
(361) 573-9181
NPI assigned
Nov 24, 2020
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1020314 TX Primary

Addresses

Primary practice location

2701 Hospital Dr
Victoria, TX 77901-5749

Mailing address

2701 Hospital Dr
Victoria, TX 77901-5749
Phone (361) 573-9181

Other names 1

  • Kelley Goins Former name

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
I20201215000720 TX Practitioner - Nurse Practitioner 6800208919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Medical Center County of VictoriaGroup PAC ID 3577785096, 102 clinicians

Practice addresses (Care Compare)

2701 Hospital Dr
Victoria, TX 77901-5749
Phone (361) 573-9181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1020314TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen's Medical Center County of Victoria CurrentSince Nov 29, 2020 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

2701 Hospital Dr
Victoria, TX 77901
Phone (361) 573-9180

2701 Hospital Dr
Fl 6
Victoria, TX 77901
Phone (361) 572-5113

2705 Hospital Dr
Ste 402
Victoria, TX 77901
Phone (361) 573-6351

2710 Hospital Dr
Ste 304
Victoria, TX 77901
Phone (361) 574-1782

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1093319774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015749",
            "telephone_number": "361-573-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015749",
            "telephone_number": "361-573-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUSS",
        "first_name": "KELLEY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1020314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "GOINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.