Individual provider Active NPI

Kelli Renae Garza, MSN, APRN, FNP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1417523036
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1035119 Issued in TX
Practice address
2000 SE Loop 410 Ste 127a
San Antonio, TX 78220-4933
Phone
(210) 447-7961
Fax
(210) 442-8973
NPI assigned
Jun 3, 2021
Last updated
Jun 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1035119 TX Primary

Addresses

Primary practice location

2000 SE Loop 410 Ste 127a
San Antonio, TX 78220-4933

Mailing address

2000 SE Loop 410 Ste 127a
San Antonio, TX 78220-4933
Phone (210) 447-7961

Other practice location 1

311 Future Dr
San Antonio, TX 78213-3481
Phone (210) 595-1183

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.villafamilyclinic.com Direct

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
I20241111000121 TX Practitioner - Nurse Practitioner 9537693874

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Family Clinic CurrentSince Jul 7, 2024 Accepting new patients
Villa Family Clinic, PC Single Specialty CurrentSince May 18, 2019 Accepting new patients

Locations

2000 SE Loop 410
Ste 127A
San Antonio, TX 78220
Phone (210) 447-7961

311 Future Dr
San Antonio, TX 78213
Phone (210) 595-1182

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25465/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kelli.garza.1@25465.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1417523036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SE LOOP 410 STE 127A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782204933",
            "telephone_number": "210-447-7961",
            "fax_number": "210-442-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SE LOOP 410 STE 127A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782204933",
            "telephone_number": "210-447-7961",
            "fax_number": "210-442-8973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Future Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782133481",
            "country_code": "US",
            "telephone_number": "210-595-1183",
            "fax_number": "210-595-1182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARZA",
        "first_name": "KELLI",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1035119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.villafamilyclinic.com",
            "affiliation": "N",
            "endpointDescription": "business  website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "2000 SE Loop 410 Ste 127A",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782204933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.