Individual provider Active NPI

Kerry Emily Santa Lucia, ACNP

  • Nurse Practitioner
  • Desoto, TX
National Provider Identifier
1669168811
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1113539 Issued in TX
Practice address
2651 Bolton Boone Dr
Desoto, TX 75115-2011
Phone
(214) 358-2300
Fax
(214) 579-6990
NPI assigned
Apr 12, 2023
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1113539 TX Primary
Acute Care Nurse Practitioner 363LA2100X 1113539 TX

Addresses

Primary practice location

2651 Bolton Boone Dr
Desoto, TX 75115-2011

Mailing address

1505 LBJ Fwy Ste 700
Dallas, TX 75234-6065
Phone (214) 358-2300

Other practice location 1

3500 W Wheatland Rd
Dallas, TX 75237-3460
Phone (214) 956-4525 ext. 71

Other practice location 2

2700 E Broad St
Mansfield, TX 76063-5899
Phone (214) 956-4525 ext. 71

Other practice location 3

1441 N Beckley Ave
Dallas, TX 75203-1201
Phone (214) 995-6921

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
I20230621001210 TX Practitioner - Nurse Practitioner 4880052018 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Baldy PLLCGroup PAC ID 6002337243, 17 clinicians
Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians
Dallas Nephrology AssociatesGroup PAC ID 3870403819, 156 clinicians

Practice addresses (Care Compare)

207 E Parkerville Rd
Desoto, TX 75115-6251
Phone (385) 454-5027

221 W Colorado Blvd
Suite 525
Dallas, TX 75208-2312
Phone 214960568175

2651 Bolton Boone Dr
Desoto, TX 75115-2011
Phone (214) 358-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1113539TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Nephrology Associates CurrentSince Aug 1, 2025 Accepting new patients
Dallas Pulmonary & Critical Care PA Acute Care CurrentSince Jun 7, 2023 Accepting new patients
Dallas Nephrology Associates CurrentSince Aug 1, 2025 Accepting new patients

Locations

1150 N Bishop Ave
Ste 100
Dallas, TX 75208
Phone (214) 956-8200

1505 Lyndon B Johnson Fwy
Ste 700
Dallas, TX 75234
Phone 21435823006012

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

2651 Bolton Boone Dr
Desoto, TX 75115

5605 N MacArthur Blvd
Ste 740
Irving, TX 75038
Phone 2149605681 ext. 75

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

Interoperability endpoints

  • FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: ksantalucia81804@direct.acumenmd.com

Organizations & group practices 4

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 2

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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1669168811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LBJ FWY STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752346065",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 BOLTON BOONE DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152011",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 W Wheatland Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752373460",
            "country_code": "US",
            "telephone_number": "214-956-4525 x71",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760635899",
            "country_code": "US",
            "telephone_number": "214-956-4525 x71",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1441 N Beckley Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752031201",
            "country_code": "US",
            "telephone_number": "214-995-6921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTA LUCIA",
        "first_name": "KERRY",
        "middle_name": "EMILY",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1113539",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1113539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.