Individual provider Active NPI

Kathryn Bobbitt

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1225899396
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1150009 Issued in TX
Practice address
2608 McDonald Rd
Tyler, TX 75701-5934
Phone
(903) 595-5514
NPI assigned
Jan 17, 2024
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1150009 TX Primary

Addresses

Primary practice location

2608 McDonald Rd
Tyler, TX 75701-5934

Mailing address

2608 McDonald Rd
Tyler, TX 75701-5934
Phone (903) 595-5514

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
I20240510001858 TX Practitioner - Nurse Practitioner 8921449737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince May 1, 2024 Accepting new patients
Etmc Physician Group Inc. CurrentSince May 1, 2024 Accepting new patients
Radiology Associates of North Texas PA Past Accepting new patients

Locations

2000 S Palestine St
Athens, TX 75751
Phone (903) 675-2216

409 Cottage Rd
Carthage, TX 75633
Phone (903) 693-3841

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

300 Wilson St
Henderson, TX 75652
Phone (903) 655-6536

501 S Ragsdale St
Jacksonville, TX 75766
Phone (903) 541-5000

2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000

117 N Winnsboro St
Quitman, TX 75783
Phone (903) 763-4505

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

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

2608 McDonald Rd
Tyler, TX 75701
Phone 903595551487262

Interoperability endpoints

  • Direct secure messaging: kbobbitt351854@ahs.direct-ci.com

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.

Hospital & facility affiliations 4

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": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1225899396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBITT",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1150009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.