Blue Agave Functional Medicine Leander PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BLUE AGAVE FUNCTIONAL MEDICINE LEANDER PLLC

Doing business as

Blue Agave Functional Medicine Clinic

Practice address

311 S Highway 183
Leander, TX 78641-1834

Phone

(830) 491-4040

Fax

(830) 584-0995

NPI assigned

Aug 12, 2026

Organization subpart

No

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

Authorized official

Name

Scott Knepper

Title

Owner

Phone

(830) 491-4040

Specialties & licenses 1

Addresses

Other names 1

• Blue Agave Functional Medicine Clinic Doing business as

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

{
    "created_epoch": "1786492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1477478923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S HIGHWAY 183",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786411834",
            "telephone_number": "830-491-4040",
            "fax_number": "830-584-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S HIGHWAY 183",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786411834",
            "telephone_number": "830-491-4040",
            "fax_number": "830-584-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE AGAVE FUNCTIONAL MEDICINE LEANDER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-12",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "KNEPPER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-491-4040"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Agave Functional Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Jayne Blake, NBCC, LPC ASSOCIATE
• David Blatchley, DC
• Rebecca Blick, OTR
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• Dana L Blomstrom, DPT
• Blue Agave Radiology Group PLLC
• Blue Water Homecare Inc. (Blue Water Senior Care LLC)
• Blue Water Hospice, LLC
• Bluebonnet Family Estates LLC
• Bluenile Medical Transport LLC

• General Practice Physician in Leander, TX
• Providers in Leander, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.