Individual provider Active NPI

Kelly Edwin Farris, M.D.

  • Family Medicine Physician
  • Murphy, TX
National Provider Identifier
1710978655
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K8143 Issued in TX
Practice address
170 East FM 544
Suite 112
Murphy, TX 75094-4080
Phone
(972) 722-6600
Fax
(972) 722-6601
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K8143 TX Primary

Addresses

Primary practice location

170 East FM 544
Suite 112
Murphy, TX 75094-4080

Mailing address

3400 W Wheatland Rd
Pav III Ste#360
Dallas, TX 75237-4408
Phone (214) 884-4700

Other identifiers 1

IdentifierTypeStateIssuer
047500601MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802000252 TX Practitioner - Family PracticePractitioner - Internal Medicine 7810968245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

5709 W Lovers LN
Dallas, TX 75209-5115
Phone (214) 351-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K8143TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Aug 8, 2016 Accepting new patients
Medhealth Family Medicine CurrentSince Aug 8, 2016 Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Locations

3400 W Wheatland Rd
Ste 360
Dallas, TX 75237

5709 W Lovers Ln
Dallas, TX 75209
Phone (214) 351-1800

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

170 E FM 544
Ste 112
Murphy, TX 75094
Phone (469) 626-3215

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Interoperability endpoints

  • Direct secure messaging: kfarris14503@dm.mhd.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1710978655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W WHEATLAND RD",
            "address_2": "PAV III STE#360",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752374408",
            "telephone_number": "214-884-4700",
            "fax_number": "214-884-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 EAST FM 544",
            "address_2": "SUITE 112",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750944080",
            "telephone_number": "972-722-6600",
            "fax_number": "972-722-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "KELLY",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K8143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047500601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murphy, TX

Sources for this page

Verify at the official NPI Registry.