Kenneth W Stackhouse Jr., F.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

607067 Issued in TX

Practice address

2606 Hospital Blvd
Corpus Christi, TX 78405-1804

Phone

(361) 902-4000

NPI assigned

May 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kenneth.stackhouse.1@31534.direct.athenahealth.com

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.

• Abk Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Alice, TX
  • NPI 1801983036

  Nurse Practitioner

  NPD (past)
• Camino Real Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Livingston, TX
  • NPI 1992871966

  Nurse Practitioner

  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243555200000",
    "number": "1508092974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "address_2": "SUITE 5200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014612",
            "telephone_number": "214-712-2000",
            "fax_number": "214-712-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 HOSPITAL BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051804",
            "telephone_number": "361-902-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKHOUSE",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-29",
        "last_updated": "2009-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "607067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SSC Nueces Retama LLC
• Michael Anthony St Angelo
• St Gabriel Corpus Opco LLC
• Julie Marie Stack
• Anita Stackhouse, SLP
• Jane O Stafford, M.D.
• Wesley W Stafford, MD
• Allison Evelyn Staley
• Lisa Lee Standlee, FNP
• Stephanie Marie Stanford

• Nurse Practitioner in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.