C Kelly Family Clinic, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N5766 Issued in TX

Legal business name

C KELLY FAMILY CLINIC, PA

Practice address

794 Generations Dr., Ste. 100
New Braunfels, TX 78130-2460

Phone

(830) 214-6411

Fax

(830) 626-8800

NPI assigned

May 9, 2010

Organization subpart

No

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

Authorized official

Name

Austin Kelly

Title

Secretary

Phone

(830) 214-6411

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Allaire Ayars, DO

  • Family Medicine Physician
  • Taylor, TX
  • NPI 1912345752
  Medicare reassignment NPD
• Jessica I Edwards, D.O.

  • Family Medicine Physician
  • Austin, TX
  • NPI 1265848121
  Medicare reassignment NPD
• Cecily Hostrup Kelly, MD

  • Family Medicine Physician
  • New Braunfels, TX
  • NPI 1881887545
  Medicare reassignment NPD
• Steven William Baugher

  • Primary Care Nurse Practitioner
  • New Braunfels, TX
  • NPI 1063083475
  NPD

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

{
    "created_epoch": "1273363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1093033573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 GENERATIONS DR., STE. 100",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "78130",
            "telephone_number": "830-214-6411",
            "fax_number": "830-626-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 GENERATIONS DR., STE. 100",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302460",
            "telephone_number": "830-214-6411",
            "fax_number": "830-626-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C KELLY FAMILY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-09",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "830-214-6411"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N5766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2151524-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215152402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Burleson
• Deborah Lynne Burley, FNP
• Mark A Burns, M.D.
• Kristin Kay Butler, LPC
• David Kevin C de Baca, DPT
• C. Brien Wofford DO, PA
• John Cadrain, PA-C
• James Cagle Jr.
• Anne Marie Calame, L.P.C
• Sean Wayne Calder, CRNA

• Family Medicine Physician in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.