Individual provider Active NPI

Michael Scott Kearney, FNP-C

  • Family Nurse Practitioner
  • Willis, TX
National Provider Identifier
1669299947
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1176471 Issued in TX
Practice address
9516 FM 1097 Rd W Ste 140
Willis, TX 77318-4976
Phone
(936) 539-4004
Fax
(936) 224-4205
NPI assigned
Sep 26, 2024
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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 1176471 TX Primary

Addresses

Primary practice location

9516 FM 1097 Rd W Ste 140
Willis, TX 77318-4976

Mailing address

9516 FM 1097 Rd W Ste 140
Willis, TX 77318-4976
Phone (936) 539-4004

Other practice location 1

20125 FM 1314
Suite A
Porter, TX 77365-7490
Phone (281) 306-2102

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
I20250618002055 TX Practitioner - Nurse Practitioner 5395256002 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

Practice addresses (Care Compare)

9516 FM 1097 Rd W
Suite 140
Willis, TX 77318-4976
Phone (936) 539-4004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1176471TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Community Health Center, Inc. CurrentSince Jun 10, 2025 Accepting new patients
Lone Star Community Health Center, Inc. CurrentSince Jun 10, 2025 Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients
Lone Star Community Health Center, Inc. Nurse Practitioner Past Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients

Locations

13905 Grangerland Rd
Conroe, TX 77306

605 S Conroe Medical Dr
Conroe, TX 77304

440 Rayford Rd
Ste 150
Spring, TX 77386

9516 FM 1097 Rd W
Ste 140
Willis, TX 77318
Phone (936) 436-5540

Interoperability endpoints

  • Direct secure messaging: michael.kearney.1@31617.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1669299947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9516 FM 1097 RD W STE 140",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773184976",
            "telephone_number": "936-539-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9516 FM 1097 RD W STE 140",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773184976",
            "telephone_number": "936-539-4004",
            "fax_number": "936-224-4205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20125 FM 1314",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Porter",
            "state": "TX",
            "postal_code": "773657490",
            "country_code": "US",
            "telephone_number": "281-306-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-26",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1176471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willis, TX

Sources for this page

Verify at the official NPI Registry.