Individual provider Active NPI

Kraig A Kvalevog

  • Physician Assistant
  • Fort Cavazos, TX
National Provider Identifier
1437218757
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02670 Issued in TX
Practice address
36065 Santa Fe Ave
Fort Cavazos, TX 76544-5060
Phone
(254) 220-5246
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02670 TX Primary

Addresses

Primary practice location

36065 Santa Fe Ave
Fort Cavazos, TX 76544-5060

Mailing address

36065 Santa Fe Ave
Fort Cavazos, TX 76544-5060
Phone (254) 553-3757

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
I20130909000480 TX Practitioner - Physician Assistant 6406099696 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA02670TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Urgent Care PLLC CurrentSince Jun 16, 2014 Accepting new patients
St. David'S Carenow Urgent Care PLLC Past Accepting new patients

Locations

300 W Central Texas Expy
Ste 115
Killeen, TX 76548
Phone (254) 383-2481

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1437218757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36065 SANTA FE AVE",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765445060",
            "telephone_number": "254-553-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36065 SANTA FE AVE",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765445060",
            "telephone_number": "254-220-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVALEVOG",
        "first_name": "KRAIG",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Cavazos, TX

Sources for this page

Verify at the official NPI Registry.