NPIMap

Individual provider Active NPI

Keith Powell

  • Physician Assistant
  • Weslaco, TX
National Provider Identifier
1407300767
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11394 Issued in TX
Practice address
1401 E 8TH St
Weslaco, TX 78596-6640
Phone
(956) 973-5110
NPI assigned
Aug 4, 2016
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X LA
Physician Assistant 363A00000X PA11394 TX Primary

Addresses

Primary practice location

1401 E 8TH St
Weslaco, TX 78596-6640

Mailing address

5816 92ND St
Lubbock, TX 79424-3629
Phone (580) 730-9131

Other practice location 1

211 4th St
Alexandria, LA 71301-8421
Phone (318) 769-3000

Other practice location 2

5501 S Expressway 77
Harlingen, TX 78550-3213
Phone (956) 365-1008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171116000240 TX Practitioner - Physician Assistant 5193009090 Reassigns benefits to 11 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital CurrentSince Jul 1, 2025 Accepting new patients
General Hospital CurrentSince Jul 1, 2025 Accepting new patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Aug 7, 2023 Accepting new patients
General Hospital CurrentSince Nov 1, 2025 Accepting new patients
Tri-State Memorial Hospital Past Accepting new patients

Locations

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

500 Indiana Ave
Winslow, AZ 86047

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1407300767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 92ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243629",
            "telephone_number": "580-730-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 8TH ST",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785966640",
            "telephone_number": "956-973-5110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 4th St",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713018421",
            "country_code": "US",
            "telephone_number": "318-769-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 S Expressway 77",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785503213",
            "country_code": "US",
            "telephone_number": "956-365-1008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KEITH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

Verify at the official NPI Registry.