Individual provider Active NPI

Kayleigh Todd, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Austin, TX
National Provider Identifier
1639558299
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
838455 Issued in VA
Practice address
2500 Burleson Rd
Apt 316
Austin, TX 78741-5609
Phone
(540) 842-4472
NPI assigned
May 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 838455 VA Primary

Addresses

Primary practice location

2500 Burleson Rd
Apt 316
Austin, TX 78741-5609

Mailing address

2500 Burleson Rd
Apt 316
Austin, TX 78741-5609
Phone (540) 842-4472

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
I20151022002398 TX Practitioner - Nurse Practitioner 3375852825 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
838455VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Dell Children'S Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Longhorn Emergency Medical Associates PA CurrentSince Sep 1, 2015 Accepting new patients

Locations

4900 Mueller Blvd
#2S
Austin, TX 78723
Phone (512) 324-3315

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4910 Mueller Blvd
Ste 100
Austin, TX 78723
Phone (206) 543-3093

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1639558299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BURLESON RD",
            "address_2": "APT 316",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787415609",
            "telephone_number": "540-842-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BURLESON RD",
            "address_2": "APT 316",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787415609",
            "telephone_number": "540-842-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "KAYLEIGH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "838455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.