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
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

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

Addresses

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

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.

Enrollment records 1

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

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

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

Locations

215 Oak Dr S
Ste E
Lake Jackson, TX 77566
Phone (409) 297-5221

Interoperability endpoints

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

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "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.