Kelsie Jordyn Speckner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13404 Issued in TX

Practice address

505 S Nolen Dr
Southlake, TX 76092-9167

Phone

(817) 424-1525

NPI assigned

Jul 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563

Merit-based Incentive Payment System (MIPS)

Final score

80.98 of 100Reported as group

Quality

66.51

Promoting interoperability

98

Improvement activities

40

Cost

71.76

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Texas Digestive Disease Consultants, PLLC

  • Gastroenterology Physician
  • Irving, TX
  • NPI 1053397331
  Medicare reassignment Care Compare group NPD (past)
• Medical Clinic of North Texas, PLLC

  • Internal Medicine Physician
  • Arlington, TX
  • NPI 1033167234
  Medicare reassignment
• Quantum Emergency Physicians PA

  • Hospitalist Physician
  • Abilene, TX
  • NPI 1215010079
  Medicare reassignment
• Medical Clinic of North Texas PLLC

  • Radiation Oncology Clinic/Center
  • Arlington, TX
  • NPI 1184131625
  NPD
• Medical Clinic of North Texas, PLLC

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1912955030

  Physician Assistant

  NPD
• Texas Digestive Disease Consultants, PLLC

  • Gastroenterology Physician
  • Southlake, TX
  • NPI 1649256546
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Regional Medical Center at Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
  • NPI 1073511762
  Care Compare affiliation

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1518529908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S NOLEN DR STE A",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929167",
            "telephone_number": "817-424-1525",
            "fax_number": "817-424-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S NOLEN DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929167",
            "telephone_number": "817-424-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECKNER",
        "first_name": "KELSIE",
        "middle_name": "JORDYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13404",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southlake Weight Loss, LLC
• Southlake Wound Care & Hyperbarics
• Kimberly Michelle Sowell, MS PT
• David K Spady, M.D.
• Specialty Surgical Services PLLC
• Grace Schuler Spencer, PSYD
• Nicole Marie Spexarth
• Maria Gabriela Spicer, LPC-A
• Spine Team Texas PA
• Spine Works Therapy-Southlake, P.L.L.C.

• Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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; Order and Referring.
• 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.