Individual provider Active NPI

Kevin Douglas Horn, NP

  • Family Nurse Practitioner
  • Clovis, NM
National Provider Identifier
1497643779
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
85746 Issued in NM
Practice address
912 W 21St St
Clovis, NM 88101-4149
Phone
(575) 904-7577
Fax
(505) 369-3406
NPI assigned
Jun 25, 2025
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 85746 NM Primary
Family Nurse Practitioner 363LF0000X RN324390 GA

Addresses

Primary practice location

912 W 21St St
Clovis, NM 88101-4149

Mailing address

2006 53Rd St
Lubbock, TX 79412-2714
Phone (817) 219-6964

Other practice location 1

6330 Riverside Plaza Ln NW Ste 100
Albuquerque, NM 87120-2682
Phone (505) 322-6687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20250926000901 NM Practitioner - Nurse Practitioner 9032614391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Mexico Center for Pain and Wellness, LLCGroup PAC ID 7214391366, 23 clinicians

Practice addresses (Care Compare)

6330 Riverside Plaza LN NW
Suite 100
Albuquerque, NM 87120-2682
Phone (505) 322-6687

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN324390GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Center for Pain and Wellness, LLC CurrentSince Sep 3, 2025 Accepting new patients
Colorado Center for Pain and Wellness, PLLC CurrentSince Sep 3, 2025 Accepting new patients

Locations

6330 Riverside Plaza Ln NW
Ste 100
Albuquerque, NM 87120
Phone (505) 322-6687

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1497643779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 53RD ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794122714",
            "telephone_number": "817-219-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014149",
            "telephone_number": "575-904-7577",
            "fax_number": "505-369-3406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6330 Riverside Plaza Ln NW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871202682",
            "country_code": "US",
            "telephone_number": "505-322-6687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORN",
        "first_name": "KEVIN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "85746",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN324390",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.