Individual provider Active NPI

Kelly Michael Sandall, DO

  • Emergency Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1194475228
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
V1608 Issued in TX
Practice address
600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone
(361) 902-4100
NPI assigned
Mar 23, 2022
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X V1608 TX Primary

Addresses

Primary practice location

600 Elizabeth St
Corpus Christi, TX 78404-2235

Mailing address

600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone (361) 902-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240828000198 TX Practitioner - Emergency Medicine 5698157295 Reassigns benefits to 2 organizations
I20251016004592 OH Practitioner - Emergency Medicine 5698157295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Emergency Physicians, PLLCGroup PAC ID 6204280480, 108 clinicians

Practice addresses (Care Compare)

1500 E Houston St
Beeville, TX 78102-5312
Phone (361) 354-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Refugio County Memorial Hospital District CurrentSince Jul 31, 2024 Accepting new patients
Refugio County Memorial Hospital District Emergency Medicine CurrentSince Jul 31, 2024 Accepting new patients
Emergency Medicine Physicians of Cincinnati, LTD. Emergency Medicine CurrentSince Oct 7, 2025 Accepting new patients
Gulf Coast Emergency Physicians, PLLC Emergency Medicine CurrentSince Jul 8, 2024 Accepting new patients

Locations

3300 Mercy Health Blvd
Cincinnati, OH 45211
Phone (513) 215-1114

2500 E Main St
Alice, TX 78332
Phone (361) 664-4376

1500 E Houston St
Beeville, TX 78102
Phone (361) 354-2000

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

107 Swift St
Refugio, TX 78377
Phone (361) 526-2321

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1194475228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042235",
            "telephone_number": "361-902-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042235",
            "telephone_number": "361-902-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDALL",
        "first_name": "KELLY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V1608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.