Individual provider Active NPI

Katy Sutton, FNP

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1356996573
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP141760 Issued in TX
Practice address
1901 Belmont Dr
Tyler, TX 75701-4338
Phone
(903) 238-5356
NPI assigned
Aug 5, 2019
Last updated
Sep 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 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 AP141760 TX Primary

Addresses

Primary practice location

1901 Belmont Dr
Tyler, TX 75701-4338

Mailing address

1250 W Mockingbird LN
Ste 550
Dallas, TX 75247-4902
Phone (469) 904-3555

Other names 1

  • Katy Kinder Collins Professional name

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
I20200124000233 TX Practitioner - Nurse Practitioner 2163857905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

5803 Stoneridge Dr
Texarkana, TX 75503-1461
Phone (903) 278-5747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP141760TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pallicare, Inc CurrentSince Aug 2, 2022 Accepting new patients
Wellmed Networks, Inc. CurrentSince Sep 27, 2021 Accepting new patients

Locations

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: katy.sutton.1@26850.direct.athenahealth.com

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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1356996573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W MOCKINGBIRD LN",
            "address_2": "STE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474902",
            "telephone_number": "469-904-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 BELMONT DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014338",
            "telephone_number": "903-238-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "KATY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATY",
            "last_name": "KINDER COLLINS",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.