Gwladys Peace Ndeffo Kengne, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1112752 Issued in TX

Practice address

4102 Clear Creek Rd Ste 107
Killeen, TX 76549-5954

Phone

(254) 466-0670

NPI assigned

Jul 21, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ucp Physicians of Central Texas, PLLCGroup PAC ID 3173697935, 99 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwladys.kengnendeffofnp.p6@direct.nextcare.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ucp Physicians of Central Texas, PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Georgetown, TX
  • NPI 1922289412
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  Medicare reassignment NPD
• Ucp Physicians of Central Texas, PLLC

  dba Baylor Scott & White Urgent Care Plus

  • Urgent Care Clinic/Center
  • Austin, TX
  • NPI 1154472967
  NPD

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1730869975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 CLEAR CREEK RD STE 107",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765495954",
            "telephone_number": "254-466-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 CLEAR CREEK RD STE 107",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765495954",
            "telephone_number": "254-466-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDEFFO KENGNE",
        "first_name": "GWLADYS",
        "middle_name": "PEACE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1112752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Michele Nash
• National Birth Centers, Inc.
• Trinette Nattiel
• Natural Relaxation LLC
• Meghan Nicole Nauck, BCBA
• Doreen Ndupu, PHARM.D.
• Enayetullah Neak, MD
• Jalen Negrone
• Dejai Nelson-Parten, LMFT ASSOCIATE
• Jules Nelson

• Family Nurse Practitioner in Killeen, TX
• Providers in Killeen, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.