Kysen Dane Sue, CPT

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

NPCN-17321-11162 Issued in TX

Practice address

4617 50TH St Ste 5
Lubbock, TX 79414-3507

Phone

(806) 599-6299

NPI assigned

Nov 27, 2024

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Med Pro Synergy, LLC

  • Point of Service
  • Lubbock, TX
  • NPI 1780400325
  NPD

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1891511432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 82ND ST, SUITE 145 / PMB 108",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79424",
            "telephone_number": "806-599-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 50TH ST STE 5",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794143507",
            "telephone_number": "806-599-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUE",
        "first_name": "KYSEN",
        "middle_name": "DANE",
        "credential": "CPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "TX",
            "license": "NPCN-17321-11162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Lynn Stumbo, MPT
• Ashley Sturgeon, MD
• Su Casa Home Health Services, LLC
• Jose A Suarez, MD
• Brandon J Sue, PA-C
• Denise Sullivan, PT
• Heather Sullivan, NP
• Sierra Lynn Sullivan, MD
• Dee Ann Summers la Fave, AUD
• Adam Jon Summers, MD

• Phlebotomy Technician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Phlebotomy Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.