Active NPI
Katie Lauren Killebrew
- Home Health Agency
- Trophy Club, TX
National Provider Identifier
1790026417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 2762 Waverley Dr
Trophy Club, TX 76262-3424 - Phone
- (469) 768-0308
- NPI assigned
- Mar 5, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 36387 | TX | |
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
2762 Waverley Dr
Trophy Club, TX 76262-3424
Mailing address
3805 Moorcroft Rd
Frisco, TX 75036-8226
Phone (361) 648-1295
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207164901 | Medicaid | TX | |
| 149984001 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36387 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LZK Holdings LLC | Home Health | Current | Accepting new patients |
Organizations & group practices 1
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.
-
dba Seniors Helping Seniors
- In Home Supportive Care Agency
- McKinney, TX
- NPI 1700541497
Home Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1790026417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3805 MOORCROFT RD",
"city": "FRISCO",
"state": "TX",
"postal_code": "750368226",
"telephone_number": "361-648-1295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2762 WAVERLEY DR",
"city": "TROPHY CLUB",
"state": "TX",
"postal_code": "762623424",
"telephone_number": "469-768-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLEBREW",
"first_name": "KATIE",
"middle_name": "LAUREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-05",
"last_updated": "2021-11-08",
"certification_date": "2021-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "36387",
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207164901",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149984001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Trophy Club, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.