Individual provider Active NPI

Ilennis Guilarte Suarez

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1851904650
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1011382 Issued in TX
Practice address
17503 Waverly Grove Dr
Houston, TX 77084-6323
Phone
(786) 440-4109
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1011382 TX
Family Nurse Practitioner 363LF0000X 1011382 TX Primary

Addresses

Primary practice location

17503 Waverly Grove Dr
Houston, TX 77084-6323

Mailing address

1155 Dairy Ashford Rd
Houston, TX 77079-3021
Phone (713) 799-2200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240326003988 TX Practitioner - Nurse Practitioner 6709223704

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1011382TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kdunn and Associates, P.a. Family PastSince Feb 13, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1851904650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 DAIRY ASHFORD RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793021",
            "telephone_number": "713-799-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17503 WAVERLY GROVE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770846323",
            "telephone_number": "786-440-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILARTE SUAREZ",
        "first_name": "ILENNIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1011382",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1011382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.