Individual provider Active NPI

Kelly A Kaczorowski, ACNS

  • Adult Health Clinical Nurse Specialist
  • Houston, TX
National Provider Identifier
1548545643
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
730700 Issued in TX
Practice address
929 Gessner Rd
Ste 2410
Houston, TX 77024-2515
Phone
(713) 242-4410
Fax
(713) 242-4412
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 730700 TX Primary

Addresses

Primary practice location

929 Gessner Rd
Ste 2410
Houston, TX 77024-2515

Mailing address

6400 Fannin St
Ste 2510
Houston, TX 77030-1521
Phone (713) 704-6772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
730700TXMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1548545643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST",
            "address_2": "STE 2510",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301521",
            "telephone_number": "713-704-6772",
            "fax_number": "713-704-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 GESSNER RD",
            "address_2": "STE 2410",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242515",
            "telephone_number": "713-242-4410",
            "fax_number": "713-242-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZOROWSKI",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "ACNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "730700",
            "primary": true
        }
    ],
    "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 Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.