Individual provider Active NPI

Kenneth Abara

  • Psychiatric/Mental Health Nurse Practitioner
  • Killeen, TX
National Provider Identifier
1902643919
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1166903 Issued in TX
Practice address
2407 Clear Creek Rd
Killeen, TX 76549-5721
Phone
(254) 519-8901
NPI assigned
Jul 9, 2024
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1166903 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1166903 TX Primary
Psychiatry Physician 2084P0800X 1166903 TX

Addresses

Primary practice location

2407 Clear Creek Rd
Killeen, TX 76549-5721

Mailing address

2201 Clear Creek Rd
Killeen, TX 76549-4110

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
I20241120002076 TX Practitioner - Nurse Practitioner 7315472883 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1166903TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Angels on the Horizon Therapeutic Center, LLC CurrentSince Sep 5, 2024 Accepting new patients
Metroplex Clinic Physicians, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Travail Adaptations Past Accepting new patients

Locations

1216 Duncan Rd
Copperas Cove, TX 76522
Phone (254) 577-4880

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

2207 Clear Creek Rd
Ste 303
Killeen, TX 76549
Phone (254) 519-8921

2407 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8803

Interoperability endpoints

  • Direct secure messaging: kabara681764@adventhealth.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1902643919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765495721",
            "telephone_number": "254-519-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABARA",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1166903",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1166903",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "1166903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.