Individual provider Active NPI

Kenneth Gerald Jr.

  • Family Nurse Practitioner
  • Desoto, TX
National Provider Identifier
1487204392
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP141564 Issued in TX
Practice address
731 W Belt Line Rd # 101
Desoto, TX 75115-4955
Phone
(972) 525-9900
Fax
(469) 333-7988
NPI assigned
Sep 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 AP141564 TX Primary

Addresses

Primary practice location

731 W Belt Line Rd # 101
Desoto, TX 75115-4955

Mailing address

PO Box 360541
Pittsburgh, PA 15251-6541
Phone (972) 525-9900

Other practice location 1

2021 N Town East Blvd Ste 500
Mesquite, TX 75150-4060
Phone (305) 470-2929

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kenneth.gerald.1@13711.direct.athenahealth.com

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
I20200827000820 TX Practitioner - Nurse Practitioner 3072930643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

2460 N Ih 35E
100 Baylor Scott and White
Waxahachie, TX 75165-5267
Phone (469) 800-9500

4001 Worth St
Dallas, TX 75246-1608

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.1 of 100Reported as group
Quality
88.97
Promoting interoperability
79
Improvement activities
40
Cost
83.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 6, 2025 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Jan 6, 2025 Accepting new patients

Locations

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

2460 N Interstate Highway 35 E
Ste 100
Waxahachie, TX 75165
Phone (469) 800-9500

Interoperability endpoints

  • Direct secure messaging: kgerald1370152@direct.sw.org
  • Direct secure messaging: kenneth.gerald.1@13711.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1487204392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360541",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152516541",
            "telephone_number": "972-525-9900",
            "fax_number": "469-333-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 W BELT LINE RD # 101",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154955",
            "telephone_number": "972-525-9900",
            "fax_number": "469-333-7988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 N Town East Blvd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "TX",
            "postal_code": "751504060",
            "country_code": "US",
            "telephone_number": "305-470-2929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERALD",
        "first_name": "KENNETH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-13",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenneth.gerald.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "731 W Belt Line Rd # 101",
            "city": "DeSoto",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751154955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.