Active NPI
Charles Lewis Kieffer, M.D.
- Emergency Medicine Physician
- Jbsa Ft Sam Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- T5944
- Practice address
- 3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504 - Phone
- (210) 916-4141
- NPI assigned
- Mar 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 67041 | MN | |
| Emergency Medicine Physician | 207P00000X | T5944 | TX | Primary |
| Emergency Medicine Physician | 207P00000X | R4465 | KY |
Addresses
Primary practice location
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (952) 463-5575
Other practice location 1
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
Other practice location 2
1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (952) 463-5575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Saint Louis University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2810 N Loop 1604
Suite 110
San Antonio, TX 78248-2230
Phone (210) 504-4837
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4465 | KY | MD | Emergency Medicine Physician |
| 67041 | MN | MD | Emergency Medicine Physician |
| T5944 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Fairmont | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-St James | Current | Accepting new patients | |
| Emergency Medicine Services of TX, PLLC | Emergency Medicine | Current | Accepting new patients |
| Mayo Clinic Health System-St James | Current | Accepting new patients | |
| Radiology Associates of Southwest Louisiana | Past | Accepting new patients |
Locations
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261
501 State St N
Waseca, MN 56093
Phone (507) 835-1210
100 E Alton Gloor Blvd
Brownsville, TX 78526
Phone (956) 350-7000
1020 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 990-1555
225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400
12285 Bandera Rd
Helotes, TX 78023
Phone (210) 575-2285
1905 E State Highway 97
Jourdanton, TX 78026
Phone (210) 614-9603
12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000
11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000
13434 Nacogdoches Rd
San Antonio, TX 78217
Phone (210) 447-7560
1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200
6402 Mallard Mdw
San Antonio, TX 78244
Phone (210) 757-5000
12805 W Interstate 10
San Antonio, TX 78249
Phone (210) 575-9805
3154 SE Military Dr
Ste 103
San Antonio, TX 78223
Phone (210) 337-0911
6700 W Interstate 10
San Antonio, TX 78201
Phone (210) 575-8289
250 E Basse Rd
Ste 101
San Antonio, TX 78209
Phone (210) 638-4159
7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564
9211 Potranco Rd
San Antonio, TX 78251
Phone (210) 575-9211
20475 State Highway 46 W
Ste 100
Spring Branch, TX 78070
Phone (830) 252-5200
26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700
Organizations & group practices 10
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.
-
- Emergency Medicine Physician
- San Antonio, TX
- NPI 1730637778
-
- Emergency Medicine Physician
- San Antonio, TX
- NPI 1245938729
-
- Multi-Specialty Clinic/Center
- Fairmont, MN
- NPI 1366410862
-
- Critical Access Hospital
- New Prague, MN
- NPI 1124035282
-
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
-
- Critical Access Hospital
- Waseca, MN
- NPI 1740256668
-
- Multi-Specialty Clinic/Center
- Saint James, MN
- NPI 1023177730
-
- Critical Access Hospital
- Saint James, MN
- NPI 1639198732
-
- Multi-Specialty Clinic/Center
- Waseca, MN
- NPI 1518494251
-
- Diagnostic Radiology Physician
- Alexandria, LA
- NPI 1033215710
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1124074273
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1689627655
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1952348021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1053842831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "952-463-5575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "JBSA FT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-4141"
}
],
"practiceLocations": [
{
"address_1": "1025 Marsh St",
"address_purpose": "LOCATION",
"city": "Mankato",
"state": "MN",
"postal_code": "560014752",
"country_code": "US",
"telephone_number": "507-625-4031",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 Wilford Hall Loop Bldg 4554",
"address_purpose": "LOCATION",
"city": "Jbsa Lackland",
"state": "TX",
"postal_code": "782365638",
"country_code": "US",
"telephone_number": "952-463-5575",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIEFFER",
"first_name": "CHARLES",
"middle_name": "LEWIS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-23",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "67041",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "T5944",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "R4465",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Ft Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.