Tricia Kelly, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

821766 Issued in TX

Practice address

1325 Pennsylvania Avenue Suite 560
Fort Worth, TX 76104

Phone

(817) 820-2890

Fax

(817) 810-0725

NPI assigned

Apr 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GHEABA

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group NPD
• Diabetes & Endocrine Associates of Tarrant County, L.L.P.

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Worth, TX
  • NPI 1851305460
  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906
  NPD

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1356848899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 BERKELEY DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288220",
            "telephone_number": "817-905-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVENUE SUITE 560",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-820-2890",
            "fax_number": "817-810-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TRICIA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "821766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkelly904362@direct.sw.org",
            "affiliation": "N",
            "address_1": "1776 N., US 287",
            "address_2": "Suite 220",
            "city": "Mansfield",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Hart Kelly, MD
• Sarah Kelly, DDS
• Sarah Kelly, M.S., CCC/SLP
• Traci Kelly, M.ED, BCBA
• Tracy Kelly, BCBA
• Cara Kelso, M.A., BCBA
• Amanda M. Kemp, LCDC
• Andrew P Kemp, OD
• Sandra Lynne Kemp, NNP
• Savannah Kemp, PA-C

• Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.