Individual provider Active NPI

Linda Susan Kouba, APN

  • Nurse Practitioner
  • Katy, TX
National Provider Identifier
1437215258
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
432245 Issued in TX
Practice address
24275 Katy Fwy Ste 400
Katy, TX 77494-7267
Phone
(346) 387-7171
Fax
(844) 703-5305
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 432245 TX Primary

Addresses

Primary practice location

24275 Katy Fwy Ste 400
Katy, TX 77494-7267

Mailing address

24275 Katy Fwy Ste 400
Katy, TX 77494-7267
Phone (346) 387-7171

Other practice location 1

3818 Wellington Ter
Fulshear, TX 77441-4064
Phone (832) 451-9158

Other practice location 2

3818 Wellington Ter
Fulshear, TX 77441-4064
Phone (832) 451-9158

Other identifiers 2

IdentifierTypeStateIssuer
094087603MedicaidTX
8Y9247OtherTXBCBS PAR PLAN

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
I20070219000307 TX Practitioner - Nurse Practitioner 1850493057 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Geriatrics Inc Nurse Practitioner CurrentSince Dec 15, 2008 Accepting new patients
Geriatric Associates of America, P.a. PastSince Feb 28, 2005 Accepting new patients
Geriatric Associates of America-Texas, PLLC Past Accepting new patients

Locations

24275 Katy Fwy
Ste 400
Katy, TX 77494
Phone (346) 387-7171

24285 Katy Fwy
Ste 300
Katy, TX 77494
Phone (346) 387-7171

1405 Valhalla Dr
Wharton, TX 77488
Phone (713) 723-9068

Organizations & group practices 3

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1437215258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24275 KATY FWY STE 400",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947267",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24275 KATY FWY STE 400",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947267",
            "telephone_number": "346-387-7171",
            "fax_number": "844-703-5305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3818 Wellington Ter",
            "address_purpose": "LOCATION",
            "city": "Fulshear",
            "state": "TX",
            "postal_code": "774414064",
            "country_code": "US",
            "telephone_number": "832-451-9158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3818 Wellington Ter",
            "address_purpose": "LOCATION",
            "city": "Fulshear",
            "state": "TX",
            "postal_code": "774414064",
            "country_code": "US",
            "telephone_number": "832-451-9158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUBA",
        "first_name": "LINDA",
        "middle_name": "SUSAN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "432245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094087603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PAR PLAN",
            "identifier": "8Y9247",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.