Individual provider Active NPI

Kendell Kaye Romero, FNP

  • Family Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1346591856
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
768856 Issued in TX
Practice address
3030 North St Ste 450
Beaumont, TX 77702-1434
Phone
(409) 832-9600
NPI assigned
Sep 24, 2012
Last updated
Apr 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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 768856 TX Primary

Addresses

Primary practice location

3030 North St Ste 450
Beaumont, TX 77702-1434

Mailing address

919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711

Other identifiers 3

IdentifierTypeStateIssuer
306585603MedicaidTX
P02601538OtherTXMCRR
1K1601OtherTXMEDICARE

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
I20121015000731 TX Practitioner - Nurse Practitioner 6002066743 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients

Locations

3030 North St
Ste 420
Beaumont, TX 77702
Phone (409) 835-2900

3030 North St
Ste 450
Beaumont, TX 77702
Phone (409) 832-9600

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

2246 Nall St
Port Neches, TX 77651
Phone (409) 344-4010

Organizations & group practices 3

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": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1346591856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NORTH ST STE 450",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021434",
            "telephone_number": "409-832-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "KENDELL",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "768856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306585603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02601538",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1K1601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.