Individual provider Active NPI

Kelly S Barber Walker, NP

  • Adult Health Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1992955041
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP117052 Issued in TX
Practice address
960 Highway 352
Mesquite, TX 75149-6892
Phone
(214) 391-2875
Fax
(214) 391-3396
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP117052 TX Primary

Addresses

Primary practice location

960 Highway 352
Mesquite, TX 75149-6892

Mailing address

960 Highway 352
Mesquite, TX 75149-6892
Phone (214) 391-2875

Other identifiers 3

IdentifierTypeStateIssuer
198337101MedicaidTX
198337102MedicaidTX
198337103MedicaidTX

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
I20081226000181 TX Practitioner - Nurse Practitioner 2062574171 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Apr 15, 2019 Accepting new patients
Texas Health Physicians Group CurrentSince Apr 15, 2019 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Domicilliary Service LLC Past Accepting new patients

Locations

960 Highway 352
Mesquite, TX 75149
Phone (214) 391-2875

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Organizations & group practices 5

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": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1992955041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 HIGHWAY 352",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751496892",
            "telephone_number": "214-391-2875",
            "fax_number": "214-391-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 HIGHWAY 352",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751496892",
            "telephone_number": "214-391-2875",
            "fax_number": "214-391-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBER WALKER",
        "first_name": "KELLY",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP117052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198337101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198337102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198337103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.