Individual provider Active NPI

Kelly S Gettig, MSN, APRN, CPNP

  • Pediatric Nurse Practitioner
  • Austin, TX
National Provider Identifier
1336259308
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
649898 Issued in TX
Practice address
4900 Mueller Blvd
Austin, TX 78723-3079
Phone
(512) 324-9999
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 649898 TX Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3079

Mailing address

1301 Barbara Jordan Blvd Ste 307
Austin, TX 78723-3080
Phone (512) 324-9999

Other practice location 1

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone (512) 628-1850

Other identifiers 3

IdentifierTypeStateIssuer
185341804MedicaidTX
825N89OtherTXBCBS
185341803MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070717000320 TX Practitioner - Nurse Practitioner 2769582998 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
649898TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Aug 1, 2017 Accepting new patients
Surgeons Who Only Care for Kids, PA CurrentSince Oct 16, 2013 Accepting new patients
Dell Children'S Medical Group CurrentSince Aug 1, 2017 Accepting new patients
Surgeons Who Only Care for Kids, PA CurrentSince Oct 16, 2013 Accepting new patients
Pediatric Surgical Subspecialists Past Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1301 Barbara Jordan Blvd
Austin, TX 78723
Phone (512) 324-0098

1301 Barbara Jordan Blvd
Ste 402
Austin, TX 78723
Phone (512) 628-1910

1301 Barbara Jordan Blvd
Ste 307
Austin, TX 78723
Phone (512) 324-0907

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

1301 Barbara Jordan Blvd
Ste 400
Austin, TX 78723
Phone (512) 708-4567

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8363/brand/2/csg/1/fhir/r4
  • Direct secure messaging: kelly.gettig.2@8363.direct.athenahealth.com

Organizations & group practices 5

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1336259308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 307",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233080",
            "telephone_number": "512-324-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "512-324-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Barbara Jordan Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787233078",
            "country_code": "US",
            "telephone_number": "512-628-1850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GETTIG",
        "first_name": "KELLY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "649898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185341804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "825N89",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185341803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.