Kaitlyn Nicole Welch
Individual provider Active NPI Family Nurse Practitioner · Breckenridge, TX
NPI 1124755905 · NPPES record last updated Jul 1, 2023
Key facts
- NPI
- 1124755905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1089089 (TX)
- Practice address
- 2802 W Walker St
Breckenridge, TX 76424-4000 - Phone
- (254) 559-7215
- NPI assigned
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DCS Medical PA
Practice addresses (Care Compare)
1115 E Tyler St
Integrity Urgent Care
Athens, TX 75751-2145
Phone (903) 292-5015
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220822001807 | TX | Practitioner - Nurse Practitioner | 9234512443 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1089089 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DCS Medical PA | Current |
Accepting new patients | |
| QV Urgent Care TX PLLC | Current |
Accepting new patients | |
| DCS Medical PA | Current |
Accepting new patients | |
| QV Urgent Care TX PLLC | Family Medicine | Current |
Accepting new patients |
Locations
1115 E Tyler St
Athens, TX 75751
Phone (903) 292-5015
3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832
1600 US Highway 79 S
Henderson, TX 75654
Phone (903) 657-9571
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1089089 | TX | |
| Family Nurse Practitioner | 363LF0000X | 1089089 | TX | Yes |
Addresses
Primary practice location
2802 W Walker St
Breckenridge, TX 76424-4000
Mailing address
2802 W Walker St
Breckenridge, TX 76424-4000
Phone (254) 559-7215
Other providers in Breckenridge, TX
- Wade B Toombs
- Wal-Mart Stores Texas LLC
- Amy Walker
- Kristin Swan Walling
- Heather Aline Webb
- Karis Nicole White
- Dale Williams
- Cody Dean Wimberley
- Kelli Windsor
- Meredith Michelle Wunsch
All providers in Breckenridge, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.