Individual provider Active NPI

Casey Duplechin Landreneau

  • Family Nurse Practitioner
  • Kilgore, TX
National Provider Identifier
1669054474
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1033921 Issued in TX
Practice address
1600 S Henderson Blvd
Kilgore, TX 75662-3518
Phone
(903) 475-3474
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 1033921 TX Primary

Addresses

Primary practice location

1600 S Henderson Blvd
Kilgore, TX 75662-3518

Mailing address

1600 S Henderson Blvd
Kilgore, TX 75662-3518
Phone (903) 475-3474

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
I20211124000266 TX Practitioner - Nurse Practitioner 6002206539 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1033921TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Telehealth Services of Texas Association Family CurrentSince Mar 17, 2023 Accepting new patients
Wound Management Specialists, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

434 Katherine Dr
Flowood, MS 39232
Phone (769) 216-3346

1540 E Main St
Allen, TX 75002
Phone (214) 383-9765

5526 S Congress Ave
Austin, TX 78745
Phone (512) 462-3820

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

3103 Fry Rd
Katy, TX 77449
Phone (281) 646-2964

1600 S Henderson Blvd
Kilgore, TX 75662
Phone (903) 215-3149

515 N 3rd St
Longview, TX 75601
Phone (903) 215-3149

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

1413 Oates Dr
Mesquite, TX 75150
Phone (972) 613-7001

2712 Highway 365
Nederland, TX 77627
Phone (409) 721-5846

9522 Broadway St
Pearland, TX 77584
Phone (713) 436-8151

1855 Gattis School Rd
Round Rock, TX 78664
Phone (512) 238-6268

16515 Lexington Blvd
Sugar Land, TX 77479
Phone (281) 980-6666

24048 Kuykendahl Rd
Tomball, TX 77375
Phone (281) 255-3897

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1669054474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S HENDERSON BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623518",
            "telephone_number": "903-475-3474",
            "fax_number": "903-367-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S HENDERSON BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623518",
            "telephone_number": "903-475-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRENEAU",
        "first_name": "CASEY",
        "middle_name": "DUPLECHIN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1033921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kilgore, TX

Sources for this page

Verify at the official NPI Registry.