Individual provider Active NPI

Kevin Mickle, FNP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1801360318
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343949 Issued in NY
Practice address
20405 State Highway 249 Ste 325
Houston, TX 77070-2893
Phone
(866) 849-0692
NPI assigned
Jan 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 29568 SC
Nurse Practitioner 363L00000X 10007611 OR
Nurse Practitioner 363L00000X 38242 TN
Nurse Practitioner 363L00000X 38242 IN
Nurse Practitioner 363L00000X 209031979 IL
Nurse Practitioner 363L00000X 4035573 KY
Family Nurse Practitioner 363LF0000X 295819 AZ
Family Nurse Practitioner 363LF0000X 1098789 TX
Family Nurse Practitioner 363LF0000X 5019513 NC
Family Nurse Practitioner 363LF0000X APRN11023651 FL
Family Nurse Practitioner 363LF0000X 0038276 OH
Family Nurse Practitioner 363LF0000X 343949 NY Primary

Addresses

Primary practice location

20405 State Highway 249 Ste 325
Houston, TX 77070-2893

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmickle46087@direct.urmc.rochester.edu Direct
Direct Messaging Address kmickle46087@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, FL, OR, NC, AZ, SC7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20190320000782 NY Practitioner - Nurse Practitioner 1052651544 Reassigns benefits to 1 organization
I20230308002101 TX Practitioner - Nurse Practitioner 1052651544 Reassigns benefits to 1 organization
I20230531001891 FL Practitioner - Nurse Practitioner 1052651544 Reassigns benefits to 1 organization
I20230707003569 OR Practitioner - Nurse Practitioner 1052651544 Reassigns benefits to 1 organization
I20240419000214 NC Practitioner - Nurse Practitioner 1052651544 Reassigns benefits to 1 organization
I20240422002851 AZ Practitioner - Nurse Practitioner 1052651544 Reassigns benefits to 1 organization
I20250128004634 SC Practitioner - Nurse Practitioner 1052651544 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209031979ILMDNurse Practitioner
38242INMDNurse Practitioner
4035573KYMDNurse Practitioner
38242TNMDNurse Practitioner
295819AZMDFamily Nurse Practitioner
APRN11023651FLMDFamily Nurse Practitioner
5019513NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devoted Medical Group Professional Corporation CurrentSince May 15, 2023 Accepting new patients
Emergency Associates - University of Rochester CurrentSince Mar 5, 2019 Accepting new patients
Devoted Medical Group of Texas Inc CurrentSince Feb 8, 2023 Accepting new patients
Devoted Medical NC PC CurrentSince Apr 8, 2024 Accepting new patients

Locations

16435 N Scottsdale Rd
Ste 285
Scottsdale, AZ 85254
Phone (520) 346-4431

880 SW 145th Ave
Ste 202
Pembroke Pines, FL 33027
Phone (615) 275-6612

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#655B
Rochester, NY 14642
Phone (585) 341-3015

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

4145 SW Watson Ave
Ste 350
Beaverton, OR 97005
Phone (503) 728-8546

220 N Main St
Ste 500
Greenville, SC 29601
Phone (347) 294-3414

20405 State Highway 249
Ste 325
Houston, TX 77070
Phone (713) 597-5114

1201 Fannin St
Ste 262
Houston, TX 77002
Phone (714) 873-6202

Interoperability endpoints

  • Direct secure messaging: kmickle46087@direct.urmc.rochester.edu
  • Direct secure messaging: kevin.mikle@xpresscaremedicalatwestside.chartmakerdirect.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1801360318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20405 STATE HIGHWAY 249 STE 325",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770702893",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLE",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "29568",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10007611",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "38242",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "38242",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209031979",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4035573",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "295819",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1098789",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019513",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023651",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0038276",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmickle46087@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmickle46087@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.