Individual provider Active NPI

Kendra Joy Vandover, NP

  • Family Nurse Practitioner
  • Lufkin, TX
National Provider Identifier
1295367795
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP144456 Issued in TX
Practice address
1717 Sayers St
Lufkin, TX 75904-1137
Phone
(936) 899-5368
NPI assigned
Feb 12, 2020
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 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 AP144456 TX Primary

Addresses

Primary practice location

1717 Sayers St
Lufkin, TX 75904-1137

Mailing address

121 Gaslight Medical Pkwy Ste 100
Lufkin, TX 75904-3154
Phone (936) 699-3141

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
I20231103003084 TX Practitioner - Nurse Practitioner 4183000664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Palliative Services PAGroup PAC ID 1951750355, 26 clinicians

Practice addresses (Care Compare)

3516 NE Stallings Dr
Suite B
Nacogdoches, TX 75965-8732
Phone (936) 585-6140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP144456TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Palliative Services PA CurrentSince Aug 1, 2024 Accepting new patients
Texas Palliative Services PA Current Accepting new patients
Texas Palliative Services PA CurrentSince Aug 1, 2024 Accepting new patients
East Texas Community Health Services, Inc PastSince Dec 21, 2025 Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

3516 NE Stallings Dr
Ste B
Nacogdoches, TX 75965
Phone (936) 585-6140

8277 Belleview Dr
Ste 275
Plano, TX 75024
Phone (469) 365-2225

Organizations & group practices 4

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1295367795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 GASLIGHT MEDICAL PKWY STE 100",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043154",
            "telephone_number": "936-699-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SAYERS ST",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759041137",
            "telephone_number": "936-899-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDOVER",
        "first_name": "KENDRA",
        "middle_name": "JOY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.