Individual provider Active NPI

Kelcei Wright

  • Licensed Vocational Nurse
  • Burleson, TX
National Provider Identifier
1568084788
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
302785 Issued in TX
Practice address
1423 Queen Annes Dr
Burleson, TX 76028-0515
Phone
(682) 232-9595
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 302785 TX Primary

Addresses

Primary practice location

1423 Queen Annes Dr
Burleson, TX 76028-0515

Mailing address

1423 Queen Annes Dr
Burleson, TX 76028-0515
Phone (682) 232-9595

Other identifiers 1

IdentifierTypeStateIssuer
110689MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL yahoo.com

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

State licenses

LicenseStateTypeSpecialty
302785TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1568084788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 QUEEN ANNES DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280515",
            "telephone_number": "682-232-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 QUEEN ANNES DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280515",
            "telephone_number": "682-232-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KELCEI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "302785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110689",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "yahoo.com",
            "affiliation": "N",
            "address_1": "1423 Queen Annes Dr",
            "city": "Burleson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760280515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.