Active NPI
Kevin Elphage Vicknair II, CSFA
- Surgical Assistant
- Austin, TX
National Provider Identifier
1144894361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 8505 Furness Dr Unit B
Austin, TX 78753-5865 - Phone
- (504) 598-2072
- NPI assigned
- May 13, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | Primary |
Addresses
Primary practice location
8505 Furness Dr Unit B
Austin, TX 78753-5865
Mailing address
1141 N Loop 1604 E Ste 105-717
San Antonio, TX 78232-1339
Phone (210) 598-2800
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nppa Services | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physician Assistant
- San Antonio, TX
- NPI 1740652197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1144894361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 N LOOP 1604 E STE 105-717",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782321339",
"telephone_number": "210-598-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8505 FURNESS DR UNIT B",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787535865",
"telephone_number": "504-598-2072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKNAIR",
"first_name": "KEVIN",
"middle_name": "ELPHAGE",
"name_suffix": "II",
"credential": "CSFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-13",
"last_updated": "2021-05-13",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.