Individual provider Active NPI

Reagan Read Kucera, APRN, FNP-C

  • Family Nurse Practitioner
  • Woodway, TX
National Provider Identifier
1558188482
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1170300 Issued in TX
Practice address
13701 Woodway Dr # 2
Woodway, TX 76712-3146
Phone
(254) 537-6900
NPI assigned
Sep 23, 2024
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1170300 TX Primary

Addresses

Primary practice location

13701 Woodway Dr # 2
Woodway, TX 76712-3146

Mailing address

13701 Woodway Dr # 2
Woodway, TX 76712-3146
Phone (254) 537-6900

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218000536 TX Practitioner - Nurse Practitioner 1456871797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

13701 W Woodway Dr Unit
2 Ascension Medical Group Providence
Woodway, TX 76712-3146
Phone (254) 537-6900

301 Richland W Cir
Providence Internal Medicine Clinic
Waco, TX 76712-7932
Phone (254) 537-6200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1170300TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Dec 19, 2024 Accepting new patients
Providence Health Alliance CurrentSince Dec 19, 2024 Accepting new patients

Locations

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

13701 Woodway Dr
Bldg 2
Woodway, TX 76712
Phone (254) 537-6900

Organizations & group practices 2

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 1

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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1558188482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13701 WOODWAY DR # 2",
            "city": "WOODWAY",
            "state": "TX",
            "postal_code": "767123146",
            "telephone_number": "254-537-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13701 WOODWAY DR # 2",
            "city": "WOODWAY",
            "state": "TX",
            "postal_code": "767123146",
            "telephone_number": "254-537-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCERA",
        "first_name": "REAGAN",
        "middle_name": "READ",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1170300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodway, TX

Sources for this page

Verify at the official NPI Registry.