Kenitra Parks, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

223286 Issued in TX

Practice address

1901 Palm Village Blvd Apt 104
Bay City, TX 77414-8147

Phone

(979) 479-5699

NPI assigned

Dec 3, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1396340501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 PALM VILLAGE BLVD APT 104",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774148147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 PALM VILLAGE BLVD APT 104",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774148147",
            "telephone_number": "979-479-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KENITRA",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "223286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Doximity",
            "affiliation": "N",
            "endpointDescription": "Healthcare app",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1901 Palm Village Blvd Apt 104",
            "city": "Bay City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774148147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Licensed Vocational Nurse in Bay City, TX
• Providers in Bay City, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.