Organization Active NPI

Corpus Christi Allergy Associates

  • Allergy & Immunology Physician
  • Corpus Christi, TX
National Provider Identifier
1093065047
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
CORPUS CHRISTI ALLERGY ASSOCIATES
Practice address
5402 S Staples St
Ste 205
Corpus Christi, TX 78411-4670
Phone
(361) 882-3487
Fax
(361) 882-3811
NPI assigned
Sep 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Ms. Candice Kennon
Title
Practice MGR
Phone
(512) 732-2774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

5402 S Staples St
Ste 205
Corpus Christi, TX 78411-4670

Mailing address

303 E Main St
Round Rock, TX 78664-5246
Phone (512) 732-2774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130325000392 TX Part B Supplier - Clinic/Group Practice 1951546837 Receives reassigned benefits from 2 practitioners
Practice locations: Corpus Christi, TX

National Provider Directory

National Provider Directory

Locations

6611 River Place Blvd
Ste 100
Austin, TX 78730
Phone (512) 373-8583

5402 S Staples St
Ste 205
Corpus Christi, TX 78411
Phone (361) 882-3487

525 Oak Centre Dr
Ste 110
San Antonio, TX 78258
Phone (210) 494-0690

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1093065047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E MAIN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786645246",
            "telephone_number": "512-732-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5402 S STAPLES ST",
            "address_2": "STE 205",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114670",
            "telephone_number": "361-882-3487",
            "fax_number": "361-882-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPUS CHRISTI ALLERGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "KENNON",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "PRACTICE MGR",
        "authorized_official_telephone_number": "512-732-2774",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.