Active NPI
Kendra Gibson
- Nurse Practitioner
- Houston, TX
National Provider Identifier
1528894870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1174109
- Practice address
- 6720 Bertner Ave
Houston, TX 77030-2604 - Phone
- (832) 355-1000
- NPI assigned
- Sep 12, 2024
- Last updated
- Sep 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1174109 | TX | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | 1174109 | TX |
Addresses
Primary practice location
6720 Bertner Ave
Houston, TX 77030-2604
Mailing address
15202 Chandler Hollow LN
Houston, TX 77049-1741
Phone (832) 477-0295
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1174109 | TX | MD | Acute Care 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": "1726099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1528894870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15202 CHANDLER HOLLOW LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770491741",
"telephone_number": "832-477-0295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6720 BERTNER AVE",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770302604",
"telephone_number": "832-355-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "KENDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-12",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1174109",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "TX",
"license": "1174109",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.