Kellum Medical Group, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KELLUM MEDICAL GROUP, PA

Practice address

7323 Marbach Rd Ste 104
San Antonio, TX 78227-1905

Phone

(210) 674-0257

Fax

(210) 369-9064

NPI assigned

May 27, 2006

Last updated

Mar 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristi Braker

Title

Contract Management

Phone

(210) 674-0257

Specialties & licenses 5

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel H Kellum Sr., DO

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1174518625
  Medicare reassignment Care Compare group NPD
• Cynthia Padilla Lafuente, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
  • NPI 1922967892
  Medicare reassignment Care Compare group NPD
• Salvador C Vazquez, MD

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1588641377
  Medicare reassignment Care Compare group NPD
• Kimberly I Diaz, PA-C

  • Medical Physician Assistant
  • San Antonio, TX
  • NPI 1366623639
  Medicare reassignment Care Compare group
• Alice T Blackmon, PNP-C

  • Pediatric Nurse Practitioner
  • San Antonio, TX
  • NPI 1265413264
  Medicare reassignment
• Arthur Lee Campsey III, PA-C

  • Medical Physician Assistant
  • Schertz, TX
  • NPI 1124424734
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1508813494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7323 MARBACH RD STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782271905",
            "telephone_number": "210-674-0257",
            "fax_number": "210-369-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7323 MARBACH RD STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782271905",
            "telephone_number": "210-674-0257",
            "fax_number": "210-369-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLUM MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "BRAKER",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "CONTRACT MANAGEMENT",
        "authorized_official_telephone_number": "210-674-0257"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DANIEL H KELLUM SR., DO - NPI",
            "identifier": "1174518625",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508813494",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADIOLOGY & X-RAY CERT#",
            "identifier": "R-14400",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAXONOMY",
            "identifier": "193200000X",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MATTHEW ARISMENDEZ, PA-C / NPI#",
            "identifier": "1346646510",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SALVADOR VAZQUEZ, MD  / NPI#",
            "identifier": "1588641377",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALICE T. BLACKMON, NP-C / NPI#",
            "identifier": "1265413264",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA - KELLUM MEDICAL GROUP, PA",
            "identifier": "45D0671939",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA - KELLUM MEDICAL GROUP, PA - PEDIATRICS",
            "identifier": "45D1026258",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANUELA BERRY, NP-C / NPI#",
            "identifier": "1063070308",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN#",
            "identifier": "00295N",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIMBERLY 'KIM' DIAZ, PA-C",
            "identifier": "1366623639",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP PTAN#",
            "identifier": "CH6982",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dean L Kellogg III, M.D.
• John Richard Kellogg, DDS
• Dean Kellogg, Jr, MD
• Karen Valentine Kellogg, DDS
• Nancy D. Kellogg, MD
• Kellum Physician Partners, PA
• Kellum Physician Partners, PA
• Alexandra Cortez Kellum, DO
• Ashley Renee Kellum, RBT
• Daniel H Kellum Sr., DO

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.