Individual provider Active NPI

Kelley Dawn Wilcher, APRN, FNP-BC

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1275186876
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142250 Issued in TX
Practice address
6049 S Hulen St
Ft. Worth, TX 76132-4815
Phone
(817) 346-3313
Fax
(817) 346-3491
NPI assigned
Jul 23, 2019
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142250 TX Primary

Addresses

Primary practice location

6049 S Hulen St
Ft. Worth, TX 76132-4815

Mailing address

1728 County Road 3791
Paradise, TX 76073-4922

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
I20200219002509 TX Practitioner - Nurse Practitioner 6901233675

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Casper Sport Chiropractic & Spine Inc CurrentSince Nov 11, 2019 Accepting new patients
Hulen Total Care PA Family Medicine Past Accepting new patients

Locations

701 Highlander Blvd
Ste 150
Arlington, TX 76015
Phone (817) 375-0235

Organizations & group practices 2

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": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1275186876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 COUNTY ROAD 3791",
            "city": "PARADISE",
            "state": "TX",
            "postal_code": "760734922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6049 S HULEN ST",
            "city": "FT. WORTH",
            "state": "TX",
            "postal_code": "761324815",
            "telephone_number": "817-346-3313",
            "fax_number": "817-346-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCHER",
        "first_name": "KELLEY",
        "middle_name": "DAWN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.