Individual provider Active NPI

Kalea Daion Elliott, CHW, MHPS

  • Community Health Worker
  • Bedford, TX
National Provider Identifier
1104565944
Registry record updated Aug 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
19037 Issued in TX
Practice address
1903 Central Dr Ste 301
Bedford, TX 76021-5813
Phone
(682) 777-5299
Fax
(855) 282-5709
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Case Manager/Care Coordinator 171M00000X
Peer Specialist 175T00000X 1581-0322 TX
Community/Behavioral Health Agency 251S00000X
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X 19037 TX Primary

Addresses

Primary practice location

1903 Central Dr Ste 301
Bedford, TX 76021-5813

Mailing address

PO Box 211631
Bedford, TX 76095-8631
Phone (972) 665-8944

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address k.elliott@fccmdfw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19037TXMDDentist
1581-0322TXMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Community Case Management Case Manager/Care Coordinator CurrentSince Jun 1, 2022 Accepting new patients

Locations

1903 Central Dr
Ste 301
Bedford, TX 76021
Phone (682) 345-5557

221 Bedford Rd
Ste 307
Bedford, TX 76022

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755388800000",
    "number": "1104565944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211631",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760958631",
            "telephone_number": "972-665-8944",
            "fax_number": "855-282-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 CENTRAL DR STE 301",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215813",
            "telephone_number": "682-777-5299",
            "fax_number": "855-282-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KALEA",
        "middle_name": "DAION",
        "credential": "CHW, MHPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2025-08-17",
        "certification_date": "2025-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "TX",
            "license": "1581-0322",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": "19037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "k.elliott@fccmdfw.org",
            "affiliation": "N",
            "address_1": "221 Bedford Rd Ste 307",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760226251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.