Individual provider Active NPI

Kathleen Jo Horne, PA-C

  • Physician Assistant
  • Lubbock, TX
National Provider Identifier
1154496974
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04625 Issued in TX
Practice address
3801 21St St
Suite 200
Lubbock, TX 79410-1006
Phone
(806) 687-0338
Fax
(806) 687-4326
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04625 TX Primary

Addresses

Primary practice location

3801 21St St
Suite 200
Lubbock, TX 79410-1006

Mailing address

3801 21St St
Lubbock, TX 79410-1006
Phone (806) 876-0338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1154496974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 21ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101006",
            "telephone_number": "806-876-0338",
            "fax_number": "806-687-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 21ST ST",
            "address_2": "SUITE 200",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101006",
            "telephone_number": "806-687-0338",
            "fax_number": "806-687-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNE",
        "first_name": "KATHLEEN",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.