Individual provider Active NPI

Kelvin Douglas Allen, RN, ACNP

  • Acute Care Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1336484963
Registry record updated Dec 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
664718 Issued in TX
Practice address
5311 Meadow Canyon Dr
Sugar Land, TX 77479-8876
Phone
(713) 298-6042
NPI assigned
Dec 8, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 664718 TX Primary

Addresses

Primary practice location

5311 Meadow Canyon Dr
Sugar Land, TX 77479-8876

Mailing address

5311 Meadow Canyon Dr
Sugar Land, TX 77479-8876
Phone (713) 298-6042

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
664718TXMDAcute Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354924800000",
    "number": "1336484963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 MEADOW CANYON DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774798876",
            "telephone_number": "713-298-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5311 MEADOW CANYON DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774798876",
            "telephone_number": "713-298-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KELVIN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "RN, ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-08",
        "last_updated": "2012-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "664718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2012; 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.