Individual provider Active NPI

Cheryl Lynn Grave Kinsella, RN, MSN, PNP

  • Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1265768576
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1105800 Issued in TX
Practice address
3200 Southwest Fwy Ste 2100
Houston, TX 77027-7525
Phone
(833) 208-7770
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383804 NY
Pediatric Nurse Practitioner 363LP0200X 277001180 IL
Pediatric Nurse Practitioner 363LP0200X 5020433 NC
Pediatric Nurse Practitioner 363LP0200X 36921 TN
Pediatric Nurse Practitioner 363LP0200X APRN11023989 FL
Pediatric Nurse Practitioner 363LP0200X R0131486 OK
Pediatric Nurse Practitioner 363LP0200X A006019 AR
Pediatric Nurse Practitioner 363LP0200X NP500017560 DC
Pediatric Nurse Practitioner 363LP0200X 2003017719 MO
Pediatric Nurse Practitioner 363LP0200X 1105800 TX Primary

Addresses

Primary practice location

3200 Southwest Fwy Ste 2100
Houston, TX 77027-7525

Mailing address

220 Athens Way # 240
Nashville, TN 37228-1311
Phone (833) 208-7770

Other practice location 1

3109 W Dr Martin Luther King Jr Blvd Ste 350
Tampa, FL 33607-6208
Phone (833) 208-7770

Other practice location 2

506 Ramseur St Ste 1
Durham, NC 27701-4890
Phone (833) 208-7770

Other names 1

  • Ms. Cheryl Lynn Burke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100716000581 MO Practitioner - Nurse Practitioner 3274665856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
A006019ARMDPediatric Nurse Practitioner
NP500017560DCMDPediatric Nurse Practitioner
APRN11023989FLMDPediatric Nurse Practitioner
277001180ILMDPediatric Nurse Practitioner
2003017719MOMDPediatric Nurse Practitioner
5020433NCMDPediatric Nurse Practitioner
383804NYMDPediatric Nurse Practitioner
R0131486OKMDPediatric Nurse Practitioner
36921TNMDPediatric Nurse Practitioner
1105800TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Children'S Palliative Care LLC CurrentSince May 31, 2020 Accepting new patients
Imagine Pediatrics of North Carolina, PLLC Pediatrics CurrentSince Feb 11, 2024 Accepting new patients
Mercy Clinic Kids Gi, LLC Past Accepting new patients
Imagine Pediatrics of Florida LLC Pediatrics PastSince Feb 11, 2024 Accepting new patients
Imagine Pediatrics PLLC Pediatrics Past Accepting new patients

Locations

615 S New Ballas Rd
Ste YG230
Saint Louis, MO 63141
Phone (314) 251-5399

607 S New Ballas Rd
Ste 2415
Saint Louis, MO 63141
Phone (314) 251-5399

506 Ramseur St
Ste 1
Durham, NC 27701

220 Athens Way
#240
Nashville, TN 37228

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27760/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1265768576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 ATHENS WAY # 240",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281311",
            "telephone_number": "833-208-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SOUTHWEST FWY STE 2100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277525",
            "telephone_number": "833-208-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3109 W Dr Martin Luther King Jr Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076208",
            "country_code": "US",
            "telephone_number": "833-208-7770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 Ramseur St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277014890",
            "country_code": "US",
            "telephone_number": "833-208-7770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "CHERYL",
        "middle_name": "LYNN GRAVE",
        "name_prefix": "Ms.",
        "credential": "RN, MSN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383804",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "277001180",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5020433",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "36921",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11023989",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "R0131486",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A006019",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "NP500017560",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2003017719",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1105800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "BURKE",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.