Individual provider Active NPI

Kimberly C. Fehlis, M.D.

  • Pediatrics Physician
  • Marble Falls, TX
National Provider Identifier
1043579253
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q5183 Issued in TX
Practice address
706 Avenue G
Marble Falls, TX 78654-5866
Phone
(830) 201-8900
NPI assigned
May 8, 2012
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q5183 TX Primary

Addresses

Primary practice location

706 Avenue G
Marble Falls, TX 78654-5866

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-8800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kfehlis75510@direct.sw.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151005001803 TX Practitioner - Pediatric Medicine 8426366808 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q5183TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Pediatrics Current Accepting new patients
Scott & White Hospital - Marble Falls Pediatrics CurrentSince Oct 15, 2019 Accepting new patients
Scott & White Clinic Pediatrics CurrentSince Jun 11, 2018 Accepting new patients
Scott & White Hospital - Marble Falls CurrentSince Oct 15, 2019 Accepting new patients
Scott and White Clinic Pediatrics CurrentSince Jun 11, 2018 Accepting new patients
Scott & White Hospital - Marble Falls Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 E Jackson St
Burnet, TX 78611
Phone (512) 756-7510

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

706 Avenue G
Marble Falls, TX 78654
Phone (830) 201-8900

810 W Highway 71
Marble Falls, TX 78654
Phone (830) 201-7100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: kfehlis75510@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1043579253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 AVENUE G",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545866",
            "telephone_number": "830-201-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEHLIS",
        "first_name": "KIMBERLY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q5183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfehlis75510@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "706 Avenue G",
            "city": "Marble Falls",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786545866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

Verify at the official NPI Registry.