NPIMap

Individual provider Active NPI

Kent P Webb, MD

  • Vascular Surgery Physician
  • Jacksonville, TX
National Provider Identifier
1104892926
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
J2917 Issued in TX
Practice address
2026 S Jackson St
Jacksonville, TX 75766-5822
Phone
(903) 586-5678
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X J2917 TX
Vascular Surgery Physician 2086S0129X J2917 TX Primary

Addresses

Primary practice location

2026 S Jackson St
Jacksonville, TX 75766-5822

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other practice location 1

2116 E Rusk St
Jacksonville, TX 75766-9052
Phone (903) 541-4545

Other practice location 2

3593 E Grande Blvd
Tyler, TX 75707-1400
Phone (903) 839-2585

Other practice location 3

619 S Fleishel Ave
Ste 203
Tyler, TX 75701-2004
Phone (903) 525-1400

Other identifiers 1

IdentifierTypeStateIssuer
115327201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805001310 TX Practitioner - Vascular SurgeryPractitioner - Emergency MedicinePractitioner - Peripheral Vascular Disease 3173594611 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: Peripheral Vascular Disease
Education
Indiana University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic Texas 1,540 clinicians

Practice addresses (Care Compare)

619 S Fleishel Ave
203 Christus Trinity Clinic
Tyler, TX 75701-2067
Phone (903) 525-1400

Hospital & facility affiliations

  • Ut Health East Texas Home Health Services Home health agency, Athens, TX, CCN 677586
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
  • Palestine Regional Medical Center Hospital, Palestine, TX, CCN 450747

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal231
Leg revascularization (restoring blood flow)18
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J2917TXMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Jacksonville CurrentSince Jan 1, 2026 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Mar 19, 1993 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince May 27, 2004 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Mar 19, 1993 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince May 27, 2004 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

2116 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664

619 S Fleishel Ave
Ste 203
Tyler, TX 75701
Phone (903) 525-1400

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

Interoperability endpoints

  • Direct secure messaging: kwebb7560@christushealth.direct-ci.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1104892926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 S JACKSON ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757665822",
            "telephone_number": "903-586-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2116 E Rusk St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757669052",
            "country_code": "US",
            "telephone_number": "903-541-4545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 S Fleishel Ave",
            "address_2": "STE 203",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012004",
            "country_code": "US",
            "telephone_number": "903-525-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBB",
        "first_name": "KENT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J2917",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "J2917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115327201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, TX

Sources for this page

Verify at the official NPI Registry.