Individual provider Active NPI

Kim Deann Tubbs, DNP PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Irving, TX
National Provider Identifier
1265786859
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
604112 Issued in TX
Practice address
6333 N State Highway 161 Ste 130
Irving, TX 75038-2421
Phone
(972) 812-0517
NPI assigned
Nov 3, 2012
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 604112 TX Primary

Addresses

Primary practice location

6333 N State Highway 161 Ste 130
Irving, TX 75038-2421

Mailing address

6333 N State Highway 161 Ste 130
Irving, TX 75038-2421
Phone (972) 812-0517

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

LicenseStateTypeSpecialty
604112TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kim D Tubbs Pmhnp PA Inc Psychiatric/Mental Health CurrentSince Aug 17, 2025 Accepting new patients

Locations

6333 N State Highway 161
Ste 130
Irving, TX 75038
Phone (972) 812-0517

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, 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": "1351900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1265786859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 N STATE HIGHWAY 161 STE 130",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382421",
            "telephone_number": "972-812-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 N STATE HIGHWAY 161 STE 130",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382421",
            "telephone_number": "972-812-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "KIM",
        "middle_name": "DEANN",
        "credential": "DNP PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-03",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "604112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.