Active NPI
Kennisha Londrea Charles, RN
- Registered Nurse
- Humble, TX
National Provider Identifier
1710488010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 70534
- Practice address
- 8530 FM 1960 Rd E
Ste 210
Humble, TX 77346-1831 - Phone
- (832) 818-5964
- Fax
- (844) 605-1814
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | 1003992 | TX | |
| Family Nurse Practitioner | 363LF0000X | 1199281 | TX | |
| Registered Nurse | 163W00000X | 70534 | TX | Primary |
Addresses
Primary practice location
8530 FM 1960 Rd E
Ste 210
Humble, TX 77346-1831
Mailing address
4403 Kenya Manor Dr
Humble, TX 77396-4317
Phone (832) 818-5964
Other practice location 1
720 Rollingbrook Dr
Baytown, TX 77521-4059
Phone (346) 787-1827
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210319000583 | TX | Practitioner - Mass Immunization Roster Biller | 4385051366 | Practice locations: Humble, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70534 | TX | MD | Registered Nurse |
| 1003992 | TX | MD | Other Specialist/Technologist |
| 1199281 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747872000000",
"number": "1710488010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4403 KENYA MANOR DR",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773964317",
"telephone_number": "832-818-5964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8530 FM 1960 RD E",
"address_2": "STE 210",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773461831",
"telephone_number": "832-818-5964",
"fax_number": "844-605-1814"
}
],
"practiceLocations": [
{
"address_1": "720 Rollingbrook Dr",
"address_purpose": "LOCATION",
"city": "Baytown",
"state": "TX",
"postal_code": "775214059",
"country_code": "US",
"telephone_number": "346-787-1827",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHARLES",
"first_name": "KENNISHA",
"middle_name": "LONDREA",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "TX",
"license": "1003992",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1199281",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "70534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.