Individual provider Active NPI

Kelly Dangre

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1477956472
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP125805 Issued in TX
Practice address
10175 Little Patuxent Pkwy
Columbia, MD 21044-2655
Phone
(512) 202-7185
NPI assigned
Oct 3, 2014
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 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 AP125805 TX Primary

Addresses

Primary practice location

10175 Little Patuxent Pkwy
Columbia, MD 21044-2655

Mailing address

10175 Little Patuxent Pkwy
Columbia, MD 21044-2655

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
I20160115001072 TX Practitioner - Nurse Practitioner 0840593331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4801 Woodway Dr
Suite 369W
Houston, TX 77056-1892
Phone (713) 622-7060

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP125805TXMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1477956472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442655",
            "telephone_number": "512-202-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANGRE",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.