Courtney Rene Kissling

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1055942 Issued in TX

Practice address

2140 N Hwy 121
Bonham, TX 75418

Phone

(430) 703-1550

NPI assigned

Oct 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Hunt Regional Urgent CareGroup PAC ID 1850729682, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hunt Regional Medical Center Hospital, Greenville, TX, CCN 450352
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckissling300825@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Hunt Regional Urgent Care

  • Urgent Care Clinic/Center
  • Greenville, TX
  • NPI 1033617931

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439

  Single Specialty

  Medicare reassignment NPD
• QV Urgent Care TX PLLC

  • Family Medicine Physician
  • Henderson, TX
  • NPI 1568098887

  Single Specialty

  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• QV Urgent Care TX PLLC

  • Rural Health Clinic/Center
  • Madisonville, TX
  • NPI 1669198347
  NPD
• Hunt Memorial Hospital District

  • Skilled Nursing Facility
  • Royse City, TX
  • NPI 1750833901
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hunt Memorial Hospital District

  • General Acute Care Hospital
  • Greenville, TX
  • NPI 1598750721
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1407518525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 N HWY 121",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "75418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 N HWY 121",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "75418",
            "telephone_number": "430-703-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1339 S Broadway St",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754824895",
            "country_code": "US",
            "telephone_number": "903-951-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5414 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757031335",
            "country_code": "US",
            "telephone_number": "903-581-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSLING",
        "first_name": "COURTNEY",
        "middle_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1055942",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1055942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph R. Strong
• Ajesh Joseph, B.P.T
• Dale Joy
• Joyce L Duran
• Huma A. Khan, M.D.
• Becky Ann Kline, RPH
• Leslie Allison Lackey, CCC-SLP
• Kjrsti Dawn Latham, AU.D.
• Joycelyn Le
• Toi Le, M.D.

• Family Nurse Practitioner in Bonham, TX
• Providers in Bonham, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.