Kellcy Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

KELLCY MEDICAL GROUP

Practice address

204 Camp Willow Rd
New Braunfels, TX 78130-1805

Phone

(830) 620-7744

Fax

(830) 625-0353

NPI assigned

Jun 10, 2024

Organization subpart

No

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

Authorized official

Name

Teri Kelso

Title

Practice Administrator

Phone

(830) 620-7744

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Simply Well Boutique Medicine Doing business as

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Holly Chapman, FNP

  • Family Nurse Practitioner
  • New Braunfels, TX
  • NPI 1730678103
  NPD
• Julia R Kellcy, D.O.

  • Internal Medicine Physician
  • New Braunfels, TX
  • NPI 1265540793
  NPD
• Sierra Joy Santellana, PA-C

  • Physician Assistant
  • Houston, TX
  • NPI 1245578046
  NPD
• Sarah Catherine Gaylord, FNP

  • Family Nurse Practitioner
  • Nashville, TN
  • NPI 1275639734
  NPD

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1740022730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CAMP WILLOW RD",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781301805",
            "telephone_number": "830-620-7744",
            "fax_number": "830-625-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CAMP WILLOW RD",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781301805",
            "telephone_number": "830-620-7744",
            "fax_number": "830-625-0353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Camp Willow Rd",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781301805",
            "country_code": "US",
            "telephone_number": "830-620-7744",
            "fax_number": "830-625-0353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLCY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "KELSO",
        "authorized_official_first_name": "TERI",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "830-620-7744"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1881813806",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simply Well Boutique Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Simply Well Boutique Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Louise Keblawi, LPC
• Keeli Stumbo MD PA
• John Edward Kehoe, MD, MPH
• Morgan Kehrberg
• Kendra Deanne Keith, MS, RD, LD, CDCES
• Kellcy Medical Group, P.a.
• Julia R Kellcy, D.O.
• Todd Alan Keller, DDS, MS
• Karen Leigh Kelley, MS
• Abigail Kelling

• Internal Medicine Physician in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.