Kathryn Anne Reveles, P.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

513440 Issued in TX

Practice address

9870 Gateway Blvd N
Ste B7
El Paso, TX 79924-4425

Phone

(915) 751-5245

Fax

(915) 751-5255

NPI assigned

Jun 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathryn.revelespnp.p104@direct.mednax.nextgenshare.com

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.

• Pediatrix Medical Group of Texas Billing, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
  • NPI 1649377359
  Medicare reassignment NPD
• Magella Medical Associates Billing, Inc.

  dba Magella Medical Associates

  • Neonatal-Perinatal Medicine Physician
  • Round Rock, TX
  • NPI 1083631071
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407850118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 WESTWIND DR",
            "address_2": "STE 310",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799121743",
            "telephone_number": "915-544-2455",
            "fax_number": "915-544-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9870 GATEWAY BLVD N",
            "address_2": "STE B7",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244425",
            "telephone_number": "915-751-5245",
            "fax_number": "915-751-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELES",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "513440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda A. Retana, LMSW
• Retis Dental PLLC
• Guillermo Alessandro Retis, DMD
• Return to Function, PLLC
• Destany Ann Reuter
• Stephanie Reveles
• Rodolfo Manuel Revilla
• Revive Global PLLC
• Revive Home Care Inc.
• Revive Home Care Inc.

• Pediatric Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.