Individual provider Active NPI

Kelly A Jones, NP

  • Adult Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1679800858
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP135985 Issued in TX
Practice address
903 W Martin St
San Antonio, TX 78207
Phone
(210) 358-3555
NPI assigned
Nov 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP135985 TX Primary

Addresses

Primary practice location

903 W Martin St
San Antonio, TX 78207

Mailing address

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3555

Other practice location 1

8122 Datapoint Dr Ste 700
San Antonio, TX 78229
Phone (210) 615-0600

Other identifiers 1

IdentifierTypeStateIssuer
400063001MedicaidTX

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
I20180710001201 TX Practitioner - Nurse Practitioner 9931380995 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP135985TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio CurrentSince Aug 1, 2019 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Aug 1, 2019 Accepting new patients
Indiana University Health, Inc Nurse Practitioner Past Accepting new patients
CCSG LLC Nurse Practitioner Past Accepting new patients

Locations

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

8122 Datapoint Dr
Ste 700
San Antonio, TX 78229
Phone (210) 615-0600

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

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": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1679800858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "210-358-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-358-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8122 Datapoint Dr Ste 700",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78229",
            "country_code": "US",
            "telephone_number": "210-615-0600",
            "fax_number": "210-615-1899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP135985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400063001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.