Individual provider Active NPI

Donna Raef Kizziar, APRN, FNP-C

  • Acute Care Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1962044941
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP143371 Issued in TX
Practice address
1400 S Coulter St
Amarillo, TX 79106-1786
Phone
(806) 414-9100
Fax
(806) 354-5717
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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 AP143371 TX
Nurse Practitioner 363L00000X AP143371 TX
Acute Care Nurse Practitioner 363LA2100X AP143371 TX Primary

Addresses

Primary practice location

1400 S Coulter St
Amarillo, TX 79106-1786

Mailing address

1400 S Coulter St
Amarillo, TX 79106-1786
Phone (806) 414-9100

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
I20191115000937 TX Practitioner - Nurse Practitioner 8628400470 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians

Practice addresses (Care Compare)

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

Hospital & facility affiliations

  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP143371TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center CurrentSince Apr 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center Amarillo CurrentSince Apr 1, 2022 Accepting new patients
Acs Primary Care Physicians Southwest, PA Nurse Practitioner CurrentSince Oct 28, 2023 Accepting new patients

Locations

1400 S Coulter St
Ste 2400
Amarillo, TX 79106
Phone (806) 414-9100

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

1400 S Coulter St
Amarillo, TX 79106
Phone (806) 354-5600

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Interoperability endpoints

  • Direct secure messaging: dkizziar23255@ahs.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1962044941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZZIAR",
        "first_name": "DONNA",
        "middle_name": "RAEF",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143371",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP143371",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP143371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.