Individual provider Active NPI

Kerry D Neal, MD

  • Obstetrics & Gynecology Physician
  • Grapevine, TX
National Provider Identifier
1417073701
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
H0090 Issued in TX
Practice address
1054 Texan TRL
Ste 100
Grapevine, TX 76051-3784
Phone
(817) 424-3112
Fax
(817) 439-6839
NPI assigned
Mar 21, 2007
Last updated
Jan 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X H0090 TX Primary

Addresses

Primary practice location

1054 Texan TRL
Ste 100
Grapevine, TX 76051-3784

Mailing address

1054 Texan TRL
Ste 100
Grapevine, TX 76051-3784
Phone (817) 424-3112

Other identifiers 1

IdentifierTypeStateIssuer
1020355-01MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110328000386 TX Practitioner - Obstetrics/Gynecology 5597948679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Tennessee, HSC, College of Medicine, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1054 Texan TRL
Suite 100
Grapevine, TX 76051-3784
Phone (817) 424-3112

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Womens Healthcare PA Obstetrics & Gynecology CurrentSince Apr 27, 1998 Accepting new patients

Locations

1054 Texan Trl
Ste 100
Grapevine, TX 76051
Phone (817) 424-2113

Organizations & group practices 1

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 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1417073701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 TEXAN TRL",
            "address_2": "STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513784",
            "telephone_number": "817-424-3112",
            "fax_number": "817-439-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 TEXAN TRL",
            "address_2": "STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513784",
            "telephone_number": "817-424-3112",
            "fax_number": "817-439-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "KERRY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "H0090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020355-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.