Individual provider Active NPI

Kyle James Hendrix, RN, CCM

  • Case Management Registered Nurse
  • Livingston, TX
National Provider Identifier
1699571034
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
1006321 Issued in TX
Practice address
106 Skyview Dr
Livingston, TX 77351-4016
Phone
(805) 709-1391
Fax
(925) 278-7157
NPI assigned
Feb 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 1006321 TX Primary

Addresses

Primary practice location

106 Skyview Dr
Livingston, TX 77351-4016

Mailing address

106 Skyview Dr
Livingston, TX 77351-4016
Phone (805) 709-1391

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1006321TXMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1699571034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SKYVIEW DR",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773514016",
            "telephone_number": "805-709-1391",
            "fax_number": "925-278-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SKYVIEW DR",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773514016",
            "telephone_number": "805-709-1391",
            "fax_number": "925-278-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "KYLE",
        "middle_name": "JAMES",
        "credential": "RN, CCM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "TX",
            "license": "1006321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.