Kelli Windsor, DO
Individual provider Active NPI Family Medicine Physician · Breckenridge, TX
NPI 1104246057 · NPPES record last updated Sep 2, 2022
Key facts
- NPI
- 1104246057
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R4651 (TX)
- Practice address
- 101 S Hartford St
Breckenridge, TX 76424-4711 - Phone
- (254) 559-3363
- Fax
- (254) 559-2547
- NPI assigned
- Apr 18, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stephens Memorial Hospital District
Stephens Memorial Hospital
Practice addresses (Care Compare)
101 S Hartford St
Breckenridge, TX 76424-4711
Phone (254) 559-3363
200 S Geneva St
Breckenridge, TX 76424-4702
Phone (254) 559-2241
Hospital & facility affiliations
- Renew Home Health
- Centerwell Home Health
- Angels Care Home Health of San Angelo
- Solaris Hospice Inc
- Stephens Memorial Hospital
- Hendrick Medical Center
- Villa Haven Health and Rehabilitation Center
- Stephens Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171110000706 | TX | Practitioner - Family Practice | 6901107226 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5842 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephens Memorial Hospital District | Current |
Accepting new patients | |
| Concord Medical Group of Texas PLLC | Current |
Accepting new patients | |
| Stephens Memorial Hospital District | Current |
Accepting new patients | |
| Stephens Memorial Hospital District | Past | Accepting new patients | |
| St John Urgent Care Clinics Inc | Past | Accepting new patients | |
| Childress County Hospital District | Past | Accepting new patients |
Locations
200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241
101 S Hartford St
Breckenridge, TX 76424
Phone (254) 559-3363
Interoperability endpoints
- kelli.windsor.1@6815.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R4651 | TX | Yes |
Addresses
Primary practice location
101 S Hartford St
Breckenridge, TX 76424-4711
Mailing address
101 S Hartford St
Breckenridge, TX 76424-4711
Phone (254) 559-3363
Other providers in Breckenridge, TX
- Heather Aline Webb
- Kaitlyn Nicole Welch
- Karis Nicole White
- Dale Williams
- Cody Dean Wimberley
- Meredith Michelle Wunsch
- Kelton Wylie
All providers in Breckenridge, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.