Individual provider Active NPI

Kelly Guillory

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1730337874
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
749155 Issued in TX
Practice address
11300 N Lamar Blvd
Austin, TX 78753-2665
Phone
(612) 225-1538
NPI assigned
Sep 3, 2008
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 749155 TX Primary

Addresses

Primary practice location

11300 N Lamar Blvd
Austin, TX 78753-2665

Mailing address

11300 N Lamar Blvd
Austin, TX 78753-2665
Phone (512) 739-8866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090326000187 TX Practitioner - Nurse Practitioner 9436216025 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Observation Medicine Services of Texas PLLC CurrentSince Mar 14, 2023 Accepting new patients
Seton Family of Doctors CurrentSince Mar 1, 2022 Accepting new patients
Minuteclinic Telehealth Services of Texas Association Family CurrentSince Aug 10, 2023 Accepting new patients
Travis County Emergency Physicians PA CurrentSince Mar 14, 2023 Accepting new patients

Locations

1540 E Main St
Allen, TX 75002
Phone (214) 383-9765

11300 N Lamar Blvd
Austin, TX 78753
Phone (512) 462-3820

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

1500 Red River St
Austin, TX 78701
Phone (512) 324-0150

3500 W Slaughter Ln
Austin, TX 78749
Phone (512) 292-6832

5526 S Congress Ave
Austin, TX 78745
Phone (512) 310-3190

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

3103 Fry Rd
Katy, TX 77449
Phone (281) 646-2964

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1413 Oates Dr
Mesquite, TX 75150
Phone (972) 613-7001

2712 Highway 365
Nederland, TX 77627
Phone (409) 721-5846

9522 Broadway St
Pearland, TX 77584
Phone (713) 436-8151

1855 Gattis School Rd
Round Rock, TX 78664
Phone (512) 238-6268

2051 Gattis School Rd
Ste 250
Round Rock, TX 78664
Phone (512) 324-4813

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: kelly.guillory.1@8363.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1730337874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787532665",
            "telephone_number": "512-739-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787532665",
            "telephone_number": "612-225-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "749155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.