KATHLEEN C BACCUS (FNP) – Family Nurse Practitioner, NPI 1033727219

KATHLEEN C BACCUS (FNP) is a healthcare provider. based in Lubbock, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 1005508 (TX). The NPI Number for KATHLEEN C BACCUS (FNP) is 1033727219

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN C BACCUS (FNP)
NPI
1033727219
Phone
(806) 791-0399
Address
4408 6TH ST
Enumeration Date
14 July 2020
Last Update Date
1 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
80676344555346
Graduation Year
2015 (11 years ago)
PAC ID
4183040959
Group Practice PAC ID
6800220682
Professional Enrollment ID
I20200812000090
Address ID
TX794155346LU3710XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for KATHLEEN C BACCUS (FNP)

  • 4408 6TH ST

    LUBBOCK, TX 794164732

    Phone: (806) 791-0399

    Fax: (806) 791-0373

    Type: Location

  • 2215 NASHVILLE AVE

    LUBBOCK, TX 794101105

    Phone: (806) 725-5844

    Fax: (806) 723-6532

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 21 Open Payments records for all available years, with a total value of $949.

Total Amount is formed as General ($949) + Research ($0) + Ownership ($0) = $949.

Last reported payment date: 2024-10-16 • Largest payer in this snapshot: ABBVIE INC. ($295).

Total Amount

$949

General + Research + Ownership

Payments

21

Total payment records

General Amount

$949

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-16

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-08-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200812000090INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 79416)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800220682View full group profile
NameSpecialtyState
Nurse PractitionerNH
Nurse PractitionerOH
Physician AssistantCT
Certified Clinical Nurse Specialist (Cns)OK
Nurse PractitionerLA
Physician AssistantME
Physician AssistantME
Physician AssistantNV
Nurse PractitionerMO
Nurse PractitionerTX

Reviews

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Frequently asked questions

Does KATHLEEN C BACCUS (FNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KATHLEEN C BACCUS (FNP) uses 1033727219.
Does CMS list KATHLEEN C BACCUS (FNP) as active?
Yes — KATHLEEN C BACCUS (FNP) is active in the NPI listing used on this page.
What is KATHLEEN C BACCUS (FNP)'s primary classification?
Family Nurse Practitioner is the headline specialty for KATHLEEN C BACCUS (FNP) here. Clinical services aligned with this taxonomy classification.
What area does KATHLEEN C BACCUS (FNP) serve?
KATHLEEN C BACCUS (FNP)'s listing highlights Lubbock, Texas; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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