Kimberly Faye Sennet, APN-CNM, PMHNP-BC

Key facts

NPI

1750658795

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

License

1056730 (TX)

Practice address

1210 Cottonwood Creek TRL Ste 230
Cedar Park, TX 78613-2688

Phone

(512) 643-6099

NPI assigned

Nov 18, 2011

Sex

Female

Sole proprietor

No

Organizations & group practices 2

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.

• The Hive Maternal Wellness Center Adult Mental Health Clinic/Center · Leander, TX · NPI 1750068094
  NPD Authorized official PSYCHIATRIC/MENTAL HEALTH
• Anew Era TMS & Psychiatry of Texas, PA Psychiatry Physician · Dallas, TX · NPI 1588251854
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.sennet.1@22469.direct.athenahealth.com
• Direct secure messaging: hivematernalwellnesscenter.kimberlysennet@154697.advancedmd-direct.com

Specialties & licenses

Addresses

Other identifiers

Other names

• Kimberly Faye Gray II Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 18, 2022.

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1750658795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 NORTHERN TRL",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786418064",
            "telephone_number": "702-203-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 COTTONWOOD CREEK TRL STE 230",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132688",
            "telephone_number": "512-643-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENNET",
        "first_name": "KIMBERLY",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "APN-CNM, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "AP124363",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1056730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750658795",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE NUMBER",
            "identifier": "1056730",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE NUMBER",
            "identifier": "AP124363",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GRAY",
            "middle_name": "FAYE",
            "suffix": "II",
            "credential": "APN-CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Cedar Park, TX · Psychiatric/Mental Health Nurse Practitioner in Texas