Individual provider Active NPI

Kathy Lea McNeese, NP-C

  • Family Nurse Practitioner
  • Nacogdoches, TX
National Provider Identifier
1477018141
Registry record updated Jul 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140465 Issued in TX
Practice address
1018 N Mound St Ste 205
Nacogdoches, TX 75961-4434
Phone
(936) 569-9472
Fax
(936) 569-4664
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 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 AP140465 TX Primary

Addresses

Primary practice location

1018 N Mound St Ste 205
Nacogdoches, TX 75961-4434

Mailing address

1204 N Mound St
Nacogdoches, TX 75961-4027
Phone (936) 568-8430

Other names 1

  • Kathy Lea Ellington Former name

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
I20190508001394 TX Practitioner - Nurse Practitioner 2769724988 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Angelina Emergency Medicine Associates PA CurrentSince Jun 12, 2024 Accepting new patients
East Texas Hematology & Oncology CurrentSince Feb 22, 2023 Accepting new patients
Memorial Multispecialty Associates Family Past Accepting new patients

Locations

1202 W Frank Ave
Lufkin, TX 75904
Phone (639) 637-6415

505 S John Redditt Dr
Lufkin, TX 75904
Phone (713) 512-1200

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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689465600000",
    "number": "1477018141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-568-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N MOUND ST STE 205",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614434",
            "telephone_number": "936-569-9472",
            "fax_number": "936-569-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEESE",
        "first_name": "KATHY",
        "middle_name": "LEA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2023-07-16",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "ELLINGTON",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.