NPIMap

Individual provider Active NPI

Kelly Colleen McDonald, M.D.

  • Family Medicine Physician
  • Brenham, TX
National Provider Identifier
1073572624
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q1674 Issued in TX
Practice address
110 Highway 290 W
Brenham, TX 77833-9165
Phone
(979) 830-5584
Fax
(979) 277-7100
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01054990A IN
Family Medicine Physician 207Q00000X 0101243704 VA
Family Medicine Physician 207Q00000X Q1674 TX Primary

Addresses

Primary practice location

110 Highway 290 W
Brenham, TX 77833-9165

Mailing address

110 Highway 290 W
Brenham, TX 77833-9165
Phone (979) 830-5584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150130002281 TX Practitioner - Family Practice 8123196904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

110 Hwy 290 W
Brenham, TX 77833-9165
Phone (979) 731-8888

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01054990AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
St Joseph Regional Health Center CurrentSince Jan 1, 2015 Accepting new patients
Shannon Clinic Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

110 Highway 290 W
Brenham, TX 77833
Phone (979) 776-5960

2800 S Texas Ave
Ste 202
Bryan, TX 77802
Phone (979) 774-2060

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

Interoperability endpoints

  • Direct secure messaging: kelly.mcdonald@sjrhc.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1073572624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HIGHWAY 290 W",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339165",
            "telephone_number": "979-830-5584",
            "fax_number": "979-277-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HIGHWAY 290 W",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339165",
            "telephone_number": "979-830-5584",
            "fax_number": "979-277-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KELLY",
        "middle_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01054990A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101243704",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q1674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.