NPIMap

Individual provider Active NPI

Carolyn Kenney

  • Obstetrics & Gynecology Physician
  • Webster, TX
National Provider Identifier
1518252907
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
125-059271 Issued in IL
Practice address
17 Professional Park Dr
Webster, TX 77598-4123
Phone
(281) 332-9511
NPI assigned
Jun 14, 2011
Last updated
Aug 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125-059271 IL Primary

Addresses

Primary practice location

17 Professional Park Dr
Webster, TX 77598-4123

Mailing address

17 Professional Park Dr
Webster, TX 77598-4123
Phone (214) 460-5205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150626000999 TX Practitioner - Obstetrics/Gynecology 6204148604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Texas HSC, College of Osteopathic Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Obstetrics and Gynecology,PAGroup PAC ID 8022068246, 4 clinicians

Practice addresses (Care Compare)

17 Professional Park Dr
Webster, TX 77598-4123
Phone 2813329511150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125-059271ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Obstetrics and Gynecology,PA CurrentSince Aug 3, 2015 Accepting new patients
Chca Clear Lake LP Past Accepting new patients
Utmb Faculty Group Practice Obstetrics & Gynecology Past Accepting new patients

Locations

17 Professional Park Dr
Webster, TX 77598
Phone (281) 332-9511

Interoperability endpoints

  • Direct secure messaging: carolyn.kenney.1@25583.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1518252907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 PROFESSIONAL PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984123",
            "telephone_number": "214-460-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 PROFESSIONAL PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984123",
            "telephone_number": "281-332-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125-059271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.