NPIMap

Individual provider Active NPI

Kathleen Weindorff Harris, MD

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1407050008
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M9089 Issued in TX
Practice address
709 Hollybrook Dr
Suite 4500
Longview, TX 75605
Phone
(903) 757-6042
Fax
(903) 232-8260
NPI assigned
Jun 14, 2007
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M9089 TX Primary

Addresses

Primary practice location

709 Hollybrook Dr
Suite 4500
Longview, TX 75605

Mailing address

PO Box 610363
Dallas, TX 75261-0363
Phone (903) 291-6187

Other names 1

  • Mrs. Kathleen Michelle Weindorff Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080804000565 TX Practitioner - Internal Medicine 7810061157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical Branch at Galveston, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

709 Hollybrook Dr
Suite 4500
Longview, TX 75605-2412
Phone (903) 757-6042

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M9089TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinicians of East Texas Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients

Locations

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

707 Hollybrook Dr
Ste 504
Longview, TX 75605
Phone (903) 232-8501

709 Hollybrook Dr
Ste 4500
Longview, TX 75605
Phone (903) 757-6042

805 Medical Cir
Longview, TX 75605
Phone (903) 232-8100

Interoperability endpoints

  • Direct secure messaging: kathleen.harris.1@23550.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.

Hospital & facility affiliations 8

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1407050008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610363",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752610363",
            "telephone_number": "903-291-6187",
            "fax_number": "903-237-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 HOLLYBROOK DR",
            "address_2": "SUITE 4500",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75605",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KATHLEEN",
        "middle_name": "WEINDORFF",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M9089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "WEINDORFF",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.