Active NPI
Kimberly Stayton, RN
- Case Manager/Care Coordinator
- Richmond, TX
National Provider Identifier
1548749203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 6719 Trinity Trail LN
Richmond, TX 77469-1952 - Phone
- (314) 546-5955
- NPI assigned
- Aug 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary | ||
| Pediatric Registered Nurse | 163WP0200X | 2001005289 | MO |
Addresses
Primary practice location
6719 Trinity Trail LN
Richmond, TX 77469-1952
Mailing address
6215 Wayne Way
Rosenberg, TX 77471-1911
Phone (314) 546-5955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000 | Medicaid | TX |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001005289 | MO | MD | Pediatric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567123200000",
"number": "1548749203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6215 WAYNE WAY",
"city": "ROSENBERG",
"state": "TX",
"postal_code": "774711911",
"telephone_number": "314-546-5955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6719 TRINITY TRAIL LN",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774691952",
"telephone_number": "314-546-5955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAYTON",
"first_name": "KIMBERLY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-13",
"last_updated": "2019-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
},
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "MO",
"license": "2001005289",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000000",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.