Kyle Kettle, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1018479 Issued in TX

Practice address

11821 East Fwy Ste 175
Houston, TX 77029-1960

Phone

(832) 548-6171

NPI assigned

Oct 30, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyle.kettle.1@15750.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/15750/brand/1/csg/1/fhir/r4
• Direct secure messaging: kkettle468735@direct.stlukeshealth.org

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.

• Doctors Express of the Beaumont Area PA

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1841525235
  Medicare reassignment NPD
• PCP Associates of Pasadena PA

  • Family Medicine Physician
  • Pasadena, TX
  • NPI 1467673301
  Medicare reassignment NPD
• Your Family Healthcare, LLC

  • Primary Care Clinic/Center
  • Santa Fe, TX
  • NPI 1043757479

  Family

  Medicare reassignment NPD
• Southlake Doctors Express, PA PSC

  • Urgent Care Clinic/Center
  • Southlake, TX
  • NPI 1942519335
  NPD
• Doctors Express of the Temple Area, PA

  • Urgent Care Clinic/Center
  • Temple, TX
  • NPI 1568696227
  NPD (past)

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1861092504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15738 N TOWER CIR",
            "city": "SANTA FE",
            "state": "TX",
            "postal_code": "775172848",
            "telephone_number": "832-548-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11821 EAST FWY STE 175",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770291960",
            "telephone_number": "832-548-6171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5030 Crenshaw Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775053141",
            "country_code": "US",
            "telephone_number": "713-943-8229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTLE",
        "first_name": "KYLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1018479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Ketcham, O.D.
• Sonya Lawon Ketchens, MD
• Roberta Borden Ketchum, LCSW
• Kete Health Center LLC
• Sachin Ketkar
• Annemarie Rose Kettler, RD
• Pamela Marie Deaver Ketwaroo, M.D.
• Emily Zhi-Yun Keung, M.D.
• Ryan M Keutzer, H.I.S.
• Kev-Fran Healthcare Services, Inc.

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, 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 Dec 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.