Kayla Underwood, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1141314 Issued in TX

Practice address

1011 S William St
Atlanta, TX 75551-3245

Phone

(903) 796-2868

Fax

(903) 927-1764

NPI assigned

Sep 14, 2023

Last updated

Nov 9, 2023By the provider in NPPES

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

Other identifiers 1

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Border Health ClinicGroup PAC ID 8820038565, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kelton Home Health Care Home health agency, Atlanta, TX, CCN 673148
• Heritage Home Health Home health agency, Texarkana, TX, CCN 458337
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• East Texas Border Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1023630969
  Medicare reassignment Care Compare group
• East Texas Border Health Clinic

  dba Genesis Prime Care

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1558329797
  NPD
• East Texas Border Health Clinic

  dba Genesis Primecare

  • Federally Qualified Health Center (FQHC)
  • Texarkana, TX
  • NPI 1598366718
  NPD
• East Texas Border Health Clinic

  dba Genesis PrimeCare Pharmacy Marshall

  • Community/Retail Pharmacy
  • Marshall, TX
  • NPI 1073485082
  NPD (past)
• East Texas Border Health Clinic

  dba Genesis PrimeCare

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1700134996
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Ark-la-Tex

  dba Christus St. Michael Health System

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba CHRISTUS St. Michael Health System

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Family Care Home Health, Inc.

  • Home Health Agency
  • Texarkana, TX
  • NPI 1558363408
  Care Compare affiliation
• Kelton Home Health Care, Inc.

  • Home Health Agency
  • Atlanta, TX
  • NPI 1639228265
  Care Compare affiliation

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1821875568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S WILLIAM ST",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755513245",
            "telephone_number": "903-796-2868",
            "fax_number": "903-927-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1141314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1141314",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TD Stanley PLLC
• Kelli Michelle Thompson, APRN, FNP-C
• Total Renal Care Inc (Northeast Texas Dialysis)
• Robert Terry Trawnik, B.C.O.
• Rosharon Shunta Turner, LPC
• Jennifer Wagner, LPC, LCDC
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 100226)
• Wal-Mart Stores Texas, LP (Vision Center 30-0226)
• Scott A Walls, M.D.
• Wesley Partners, LTD. (Wesley House)

• Family Nurse Practitioner in Atlanta, TX
• Providers in Atlanta, 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 Nov 9, 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.