Individual provider Active NPI

Kayse Freehauf, FNP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1417507245
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP143039 Issued in TX
Practice address
4900 White Settlement Rd.
Fort Worth, TX 76114
Phone
(817) 241-2485
Fax
(817) 887-9158
NPI assigned
Sep 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP143039 TX Primary

Addresses

Primary practice location

4900 White Settlement Rd.
Fort Worth, TX 76114

Mailing address

4900 White Settlement Rd.
Fort Worth, TX 76114
Phone (817) 241-2485

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011002743 TX Order and Referring Only - Nurse Practitioner 8820443831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Godley Family Medicine Clinic Family PastSince Jan 21, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1417507245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 WHITE SETTLEMENT RD.",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76114",
            "telephone_number": "817-241-2485",
            "fax_number": "817-887-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 WHITE SETTLEMENT RD.",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76114",
            "telephone_number": "817-241-2485",
            "fax_number": "817-887-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEHAUF",
        "first_name": "KAYSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.