Individual provider Active NPI

Kimi L Dart, D.O.

  • Otolaryngology Physician
  • Lake Jackson, TX
National Provider Identifier
1881887867
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
P6804 Issued in TX
Practice address
215 Oak Dr S Ste E
Lake Jackson, TX 77566-5617
Phone
(979) 258-5445
Fax
(979) 258-6030
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of North Texas HSC, College of Osteopathic Med, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 Oak Dr S
Suite E
Lake Jackson, TX 77566-5617
Phone (979) 258-5445

Hospital & facility affiliations

  • CHI St Luke'S Health Brazosport Hospital, Lake Jackson, TX, CCN 450072

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

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: Yes
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20130703000194 TX Practitioner - Otolaryngology 1052551611 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
P6804TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kimi Dart, DO, PLLC Otolaryngology CurrentSince Mar 1, 2021 Accepting new patients
CLS Health PLLC Past Accepting new patients

Locations

215 Oak Dr S
Ste E
Lake Jackson, TX 77566
Phone (979) 258-5445

Interoperability endpoints

  • Direct secure messaging: kdart067@yourcarecommunity.org
  • Direct secure messaging: kdart@lakejacksonent.emadirect.md
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFFDBA

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X P6804 TX Primary
Facial Plastic Surgery Physician 207YS0123X P6804 TX

Addresses

NPPES NPI Registry

Primary practice location

215 Oak Dr S Ste E
Lake Jackson, TX 77566-5617

Mailing address

PO Box 58538
Webster, TX 77598-8538

Other practice location 1

500 N Kobayashi Ste C
Webster, TX 77598-4722
Phone (281) 816-3092

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 1, 2026.

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1881887867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58538",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775988538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OAK DR S STE E",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665617",
            "telephone_number": "979-258-5445",
            "fax_number": "979-258-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N Kobayashi Ste C",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775984722",
            "country_code": "US",
            "telephone_number": "281-816-3092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DART",
        "first_name": "KIMI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "P6804",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TX",
            "license": "P6804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.