Individual provider Active NPI

Skye A Kienitz, RN

  • Registered Nurse
  • Fort Worth, TX
National Provider Identifier
1972467108
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
258607 Issued in TN
Practice address
1228 Gould Ave
Fort Worth, TX 76164-9013
Phone
(708) 262-9673
NPI assigned
Dec 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 258607 TN Primary

Addresses

Primary practice location

1228 Gould Ave
Fort Worth, TX 76164-9013

Mailing address

1228 Gould Ave
Fort Worth, TX 76164-9013
Phone (708) 262-9673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
258607TNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1765411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1972467108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 GOULD AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761649013",
            "telephone_number": "708-262-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 GOULD AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761649013",
            "telephone_number": "708-262-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENITZ",
        "first_name": "SKYE",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "258607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.