Individual provider Active NPI

Kori Denee Anthony, FNP-C, FNP-BC

  • Family Nurse Practitioner
  • Cleburne, TX
National Provider Identifier
1356912422
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1031569 Issued in TX
Practice address
505 N Ridgeway Dr Ste 195
Cleburne, TX 76033-5156
Phone
(817) 774-2123
Fax
(817) 774-2128
NPI assigned
Jul 8, 2021
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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 1031569 TX Primary

Addresses

Primary practice location

505 N Ridgeway Dr Ste 195
Cleburne, TX 76033-5156

Mailing address

1420 N Galloway Ave Ste B
Mesquite, TX 75149-2326
Phone (972) 285-6703

Other practice location 1

9301 Wildcat Rdg
Godley, TX 76044-1188
Phone (903) 216-5629

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
I20210721001284 TX Practitioner - Nurse Practitioner 6608279187

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1420 N Galloway Ave
Suite B
Mesquite, TX 75149-2326

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Naomi R. Harman, M.D., P.a. CurrentSince Oct 20, 2024 Accepting new patients
Mesquite Chiropractic Health Center PastSince Jul 1, 2021 Accepting new patients

Locations

219 N Ridgeway Dr
Ste A
Cleburne, TX 76033
Phone (817) 774-2123

505 N Ridgeway Dr
Ste 195
Cleburne, TX 76033
Phone (817) 774-2123

825 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 551-1856

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11541/brand/24/csg/181/fhir/r4

Organizations & group practices 2

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": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1356912422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N GALLOWAY AVE STE B",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492326",
            "telephone_number": "972-285-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N RIDGEWAY DR STE 195",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760335156",
            "telephone_number": "817-774-2123",
            "fax_number": "817-774-2128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9301 Wildcat Rdg",
            "address_purpose": "LOCATION",
            "city": "Godley",
            "state": "TX",
            "postal_code": "760441188",
            "country_code": "US",
            "telephone_number": "903-216-5629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "KORI",
        "middle_name": "DENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1031569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.