Individual provider Active NPI

Richard Kellermayer, MD

  • Pediatric Gastroenterology Physician
  • Houston, TX
National Provider Identifier
1174781546
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
N0154 Issued in TX
Practice address
6701 Fannin St
Houston, TX 77030-2316
Phone
(832) 824-7243
NPI assigned
Jun 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X N0154 TX Primary
Pediatric Gastroenterology Physician 2080P0206X TEMP TX

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030-2316

Mailing address

2 Greenway PLZ
Suite 900
Houston, TX 77046-0297
Phone (713) 798-1750

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080723000323 TX Practitioner - Gastroenterology 3375616477 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6701 Fannin St
Ste 1420
Houston, TX 77030
Phone (832) 822-4240

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

1102 Bates Ave
Houston, TX 77030
Phone (832) 822-4556

Organizations & group practices 2

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1174781546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENWAY PLZ",
            "address_2": "SUITE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460297",
            "telephone_number": "713-798-1750",
            "fax_number": "713-798-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302316",
            "telephone_number": "832-824-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMAYER",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-02",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "N0154",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "TEMP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.