Active NPI
Kellys Health Care Inc
- Home Health Agency
- Mission, TX
National Provider Identifier
1124045984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 004197
- Legal business name
- KELLYS HEALTH CARE INC
- Practice address
- 2007 N Conway Ave
Mission, TX 78572-2947 - Phone
- (956) 519-8118
- Fax
- (956) 584-8572
- NPI assigned
- Jul 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jaynie Chapa, RN
- Title
- RN/Administrator
- Phone
- (956) 519-8118
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 004197 | TX | Primary |
Addresses
Primary practice location
2007 N Conway Ave
Mission, TX 78572-2947
Mailing address
2007 N Conway Ave
Mission, TX 78572-2947
Phone (956) 519-8118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025042501 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
2007 N Conway Ave
Ste C
Mission, TX 78572
2007 N Conway Ave
Mission, TX 78572
Phone (956) 519-8118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1577664000000",
"number": "1124045984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2007 N CONWAY AVE",
"city": "MISSION",
"state": "TX",
"postal_code": "785722947",
"telephone_number": "956-519-8118",
"fax_number": "956-584-8572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2007 N CONWAY AVE",
"city": "MISSION",
"state": "TX",
"postal_code": "785722947",
"telephone_number": "956-519-8118",
"fax_number": "956-584-8572"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KELLYS HEALTH CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-17",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A",
"authorized_official_last_name": "CHAPA",
"authorized_official_first_name": "JAYNIE",
"authorized_official_title_or_position": "RN/ADMINISTRATOR",
"authorized_official_telephone_number": "956-519-8118",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TX",
"license": "004197",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "025042501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.