Individual provider Active NPI

Kelly B Cox, NP

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1356489264
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
651988 Issued in TX
Practice address
1910 Roseland Blvd
Tyler, TX 75701
Phone
(902) 533-0644
Fax
(903) 533-0644
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 651988 TX Primary

Addresses

Primary practice location

1910 Roseland Blvd
Tyler, TX 75701

Mailing address

220 Bayhills Dr
Hideaway, TX 75771-5059
Phone (903) 882-5117

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
I20070807000361 TX Practitioner - Nurse Practitioner 3870684756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyler Internal Medicine Associates, P.aGroup PAC ID 3476541731, 14 clinicians

Practice addresses (Care Compare)

1379 Brad Cir
Suite a
Lindale, TX 75771-6666
Phone (903) 881-5165

Hospital & facility affiliations

  • Traditions Health Home health agency, Tyler, TX, CCN 457951
  • Vitalcaring Group Home health agency, Sulphur Springs, TX, CCN 679076
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Internal Medicine Associates, P.a. Nurse Practitioner CurrentSince Sep 4, 2018 Accepting new patients
Smith Emergency Medicine Associates PA Nurse Practitioner Past Accepting new patients
Athens Emergency Medicine Associates PA Nurse Practitioner Past Accepting new patients
East Texas Medical Center Healthcare Associates Past Accepting new patients

Locations

1379 Brad Cir
Lindale, TX 75771
Phone (903) 881-5165

1379 Brad Cir
Ste A
Lindale, TX 75771
Phone (903) 881-5165

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1910 Roseland Blvd
Tyler, TX 75701
Phone (903) 533-0644

Interoperability endpoints

  • Direct secure messaging: kelly.cox@tima.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ADCFBA

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1356489264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BAYHILLS DR",
            "city": "HIDEAWAY",
            "state": "TX",
            "postal_code": "757715059",
            "telephone_number": "903-882-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ROSELAND BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "902-533-0644",
            "fax_number": "903-533-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COX",
        "first_name": "KELLY",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "651988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.