Kelly Offutt, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L2516 Issued in TX

Practice address

706 Ave G
Marble Falls, TX 78654-5866

Phone

(830) 693-8234

Fax

(830) 693-9090

NPI assigned

Nov 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Scott & White Clinic

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704

  Pediatrics

  Medicare reassignment NPD
• Scott & White Hospital - Marble Falls

  • Internal Medicine Physician
  • Marble Falls, TX
  • NPI 1295397859

  Pediatrics

  Medicare reassignment NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796

  Pediatrics

  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • College Station, TX
  • NPI 1922061993

  Pediatrics

  NPD
• Scott & White Hospital - Marble Falls

  • Rural Health Clinic/Center
  • Horseshoe Bay, TX
  • NPI 1821399767
  NPD
• Scott & White Hospital - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1154303709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 AVE G",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545866",
            "telephone_number": "830-693-8234",
            "fax_number": "830-693-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFUTT",
        "first_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L2516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "131964100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8F9833",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCOTT & WHITE",
            "identifier": "80803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155204401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155204402",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "koffutt11418@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "706 Ave G",
            "city": "Marble Falls",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786545866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stuart Matern Nunnally, D.D.S.
• Joy O'Neal, M-F.A.
• Ann Marie S Ocallaghan, RN CRNA
• Ryan Odders, APRN, FNP-C
• Amy L Offutt, MD
• Akasha Deja Esmeria Ojeda
• Abby Jo Oliver
• Omdx Assist, PLLC
• Jennifer L Oney, NNP-BC
• Christian M Orense, PT

• Pediatrics Physician in Marble Falls, TX
• Providers in Marble Falls, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.