Individual provider Active NPI

Kaitlyn Wise

  • Acute Care Nurse Practitioner
  • Webster, TX
National Provider Identifier
1619778909
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1193511 Issued in TX
Practice address
500 W Medical Center Blvd
Webster, TX 77598-4220
Phone
(281) 338-3708
NPI assigned
Mar 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1193511 TX Primary

Addresses

Primary practice location

500 W Medical Center Blvd
Webster, TX 77598-4220

Mailing address

18215 Hereford LN
Houston, TX 77058-3433

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
I20250408003917 TX Practitioner - Nurse Practitioner 7911421250 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
Urgent Specialty Associates of Texas PLLCGroup PAC ID 6507258209, 68 clinicians

Practice addresses (Care Compare)

500 W Medical Ctr Blvd
Webster, TX 77598-4220
Phone (281) 332-2511

Hospital & facility affiliations

  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Specialty Associates of Texas, PLLC CurrentSince Mar 21, 2025 Accepting new patients

Locations

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

500 W Medical Center Blvd
Webster, TX 77598
Phone (713) 447-4650

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 and National Provider Directory roles.

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": "1742515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1619778909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18215 HEREFORD LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984220",
            "telephone_number": "281-338-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1193511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.