Individual provider Active NPI

Kashaelyn Lanieca Hollins-Henderson, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1912493230
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP137971 Issued in TX
Practice address
3900 N Tarrant Pkwy Ste 104
Fort Worth, TX 76244-5410
Phone
(682) 333-1804
Fax
(682) 223-1346
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP137971 TX Primary

Addresses

Primary practice location

3900 N Tarrant Pkwy Ste 104
Fort Worth, TX 76244-5410

Mailing address

705 Camelia CT
Desoto, TX 75115-1521
Phone (214) 280-0266

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
I20190122002769 TX Practitioner - Nurse Practitioner 9931446440 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1795 N Hwy 77
Suite 104
Waxahachie, TX 75165-7886
Phone (214) 764-3943

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centric Family Clinic LLC Family Current Accepting new patients
Odette Louise Campbell MD PA CurrentSince Aug 1, 2018 Accepting new patients
J Olivieri Professional Health Network LLC CurrentSince May 20, 2021 Accepting new patients
Hephzibah Visiting Clinicians Family CurrentSince Dec 9, 2019 Accepting new patients
LTH Family Medicine Family CurrentSince Jan 26, 2021 Accepting new patients
Waxahachie Chiropractic CurrentSince Mar 1, 2024 Accepting new patients
Complete Health Services LLC PastSince Oct 1, 2021 Accepting new patients

Locations

610 Uptown Blvd
Ste 2000
Cedar Hill, TX 75104
Phone (972) 290-9134

3910 Gaston Ave
Ste 140
Dallas, TX 75246
Phone (214) 381-1910

111 Executive Way
Ste 102
Desoto, TX 75115
Phone (469) 585-8129

1312 14th St
Ste 101
Plano, TX 75074
Phone (214) 210-2911

5072 W Plano Pkwy
Ste 220
Plano, TX 75093
Phone (469) 671-0900

1795 N Highway 77
Ste 104
Waxahachie, TX 75165
Phone (214) 764-3943

Interoperability endpoints

  • Direct secure messaging: kashaelyn.hollinshenderson@lfm-tx1.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1912493230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 CAMELIA CT",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751151521",
            "telephone_number": "214-280-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N TARRANT PKWY STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445410",
            "telephone_number": "682-333-1804",
            "fax_number": "682-223-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINS-HENDERSON",
        "first_name": "KASHAELYN",
        "middle_name": "LANIECA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.