Individual provider Active NPI

Kimberey Calloway, REGISTERED NURSE

  • Case Manager/Care Coordinator
  • Fort Worth, TX
National Provider Identifier
1669746772
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
975583 Issued in TX
Practice address
5125 Wichita St
15283
Fort Worth, TX 76119-2541
Phone
(682) 301-2844
NPI assigned
Mar 7, 2012
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 975583 TX
Case Management Registered Nurse 163WC0400X 975583 TX
Community Health Registered Nurse 163WC1500X 975583 TX
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 975583 TX
Psychiatric/Mental Health Registered Nurse 163WP0808X 975583 TX
Case Manager/Care Coordinator 171M00000X 975583 TX Primary
Health & Wellness Coach 171400000X 975583 TX

Addresses

Primary practice location

5125 Wichita St
15283
Fort Worth, TX 76119-2541

Mailing address

PO Box 15283
Fort Worth, TX 76119-0283
Phone (682) 301-2844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
975583TXMDHealth & Wellness Coach

Practice roles

OrganizationSpecialtyStatusNew patients
Texas House of Hope Mental Health CurrentSince Mar 11, 2025 Accepting new patients
A Brighter Start Youth and Family Services Current Accepting new patients
Trucity Solutions LLC CurrentSince Feb 11, 2024 Accepting new patients

Locations

5125 Wichita St
Unit 15283
Fort Worth, TX 76119
Phone (682) 301-2844

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, 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": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1669746772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15283",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761190283",
            "telephone_number": "682-301-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 WICHITA ST",
            "address_2": "15283",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761192541",
            "telephone_number": "682-301-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLOWAY",
        "first_name": "KIMBEREY",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "975583",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "TX",
            "license": "975583",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "975583",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "TX",
            "license": "975583",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "975583",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "975583",
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "TX",
            "license": "975583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.