Individual provider Active NPI

Ke'Marvin Tyrone Pitts

  • Clinical Social Worker
  • Richardson, TX
National Provider Identifier
1215810395
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116486 Issued in TX
Practice address
3030 Waterview Pkwy
Richardson, TX 75080-1400
Phone
(972) 669-7070
NPI assigned
Jul 28, 2025
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 116486 TX Primary

Addresses

Primary practice location

3030 Waterview Pkwy
Richardson, TX 75080-1400

Mailing address

3030 Waterview Pkwy
Richardson, TX 75080-1400
Phone (972) 669-7070

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250917000148 TX Practitioner - Clinical Social Worker 6608370325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Tennessee, HSC, College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3030 Waterview Pkwy
Richardson, TX 75080-1400
Phone (972) 669-7101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116486TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 6, 2025 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 6, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

1430 Empire Central Dr
Dallas, TX 75247
Phone (214) 645-8500

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1215810395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 WATERVIEW PKWY",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801400",
            "telephone_number": "972-669-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 WATERVIEW PKWY",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801400",
            "telephone_number": "972-669-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTS",
        "first_name": "KE'MARVIN",
        "middle_name": "TYRONE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "116486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.