Individual provider Active NPI

Jack Britton Kyle Jr., RN

  • Certified Registered Nurse Anesthetist
  • Lubbock, TX
National Provider Identifier
1316063308
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP108453 Issued in TX
Practice address
3713 24TH St
Lubbock, TX 79410-2015
Phone
(217) 853-2284
NPI assigned
Mar 21, 2007
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP108453 TX Primary
Registered Nurse 163W00000X 583215 TX

Addresses

Primary practice location

3713 24TH St
Lubbock, TX 79410-2015

Mailing address

3713 24TH St
Lubbock, TX 79410-2015
Phone (217) 853-2284

Other identifiers 2

IdentifierTypeStateIssuer
84894UOtherTXBCBS
119911906MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413000872 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042257875 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas Eye PAGroup PAC ID 5294782389, 23 clinicians
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

12210 Quaker Ave
Lubbock, TX 79424-7789
Phone (806) 792-5900

3610 24TH St
Suite B
Lubbock, TX 79410-2014
Phone (806) 797-1015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
583215TXMDRegistered Nurse
AP108453TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Eye PA CurrentSince Mar 3, 2025 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
West Texas Eye PA CurrentSince Mar 3, 2025 Accepting new patients
Renaissance Medical Foundation Current Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
McAllen Anesthesia Consultants, PA Current Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Sep 11, 2023 Accepting new patients
McAllen Anesthesia Consultants, PA CurrentSince Feb 10, 2023 Accepting new patients

Locations

63 S Rockford Dr
Ste 220
Tempe, AZ 85288

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

12210 Quaker Ave
Lubbock, TX 79424
Phone (806) 792-5900

3610 24th St
Ste B
Lubbock, TX 79410
Phone (806) 797-1015

3611 50th St
Lubbock, TX 79413
Phone (806) 792-5900

5109 80th St
Lubbock, TX 79424
Phone (806) 792-5900

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Interoperability endpoints

  • Direct secure messaging: jack.kyle.p30@direct.avp.nextgenshare.com

Organizations & group practices 9

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1316063308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794102015",
            "telephone_number": "217-853-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3713 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794102015",
            "telephone_number": "217-853-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "JACK",
        "middle_name": "BRITTON",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP108453",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "583215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84894U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119911906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.