Active NPI
Keena Joy Ennis Chung, CFNP, CPNP-AC
- Acute Care Nurse Practitioner
- Austin, TX
National Provider Identifier
1245263805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 741808
- Practice address
- 4900 Mueller Blvd
Dell Children's Medical Center
Austin, TX 78723-3079 - Phone
- (512) 324-0000
- Fax
- (512) 324-0721
- NPI assigned
- Jul 8, 2006
- Last updated
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP115959 | TX | |
| Acute Care Nurse Practitioner | 363LA2100X | 741808 | TX | Primary |
Addresses
Primary practice location
4900 Mueller Blvd
Dell Children's Medical Center
Austin, TX 78723-3079
Mailing address
4900 Mueller Blvd
Dell Children's Medical Center
Austin, TX 78723
Phone (512) 324-0000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y0195445 | Other | TX | DPS |
| 7770 | Other | TX | PRESCRIPTIVE AUTHORITY |
| 741808 | Other | TX | LICENSE NUMBER |
Other names 1
- Keena Joy Ennis
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 741808 | TX | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1245263805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 MUELLER BLVD",
"address_2": "DELL CHILDREN'S MEDICAL CENTER",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78723",
"telephone_number": "512-324-0000",
"fax_number": "512-324-0721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 MUELLER BLVD",
"address_2": "DELL CHILDREN'S MEDICAL CENTER",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787233079",
"telephone_number": "512-324-0000",
"fax_number": "512-324-0721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "KEENA",
"middle_name": "JOY ENNIS",
"name_prefix": "Ms.",
"credential": "CFNP, CPNP-AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "AP115959",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "TX",
"license": "741808",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DPS",
"identifier": "Y0195445",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESCRIPTIVE AUTHORITY",
"identifier": "7770",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "741808",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KEENA",
"last_name": "ENNIS",
"middle_name": "JOY",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.