Individual provider Active NPI

Kelleah Colleen Powao, NP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1811604218
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1098367 Issued in TX
Practice address
607 Camden St
San Antonio, TX 78215-1610
Phone
(210) 374-5257
NPI assigned
Nov 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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 1098367 TX Primary

Addresses

Primary practice location

607 Camden St
San Antonio, TX 78215-1610

Mailing address

607 Camden St
San Antonio, TX 78215-1610
Phone (210) 374-5257

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
I20230210001493 TX Practitioner - Nurse Practitioner 9032581483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Liver Consultants PAGroup PAC ID 6103063078, 36 clinicians

Practice addresses (Care Compare)

4751 Hamilton Wolfe Rd
Suite 200
San Antonio, TX 78229-3458
Phone (210) 233-7126

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1098367TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Nov 28, 2023 Accepting new patients
Texas Liver Consultants PA CurrentSince Nov 3, 2022 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Nov 28, 2023 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients

Locations

607 Camden St
Ste 108
San Antonio, TX 78215
Phone (210) 325-8402

4318 De Zavala Rd
Bldg 4
San Antonio, TX 78249

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

4751 Hamilton Wolfe Rd
Ste 200
San Antonio, TX 78229
Phone (210) 233-7126

607 Camden St
San Antonio, TX 78215
Phone (210) 374-5257

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

Interoperability endpoints

  • Direct secure messaging: kelleah.powao@commsa.eclinicaldirectplus.com

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.

Hospital & facility affiliations 1

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": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1811604218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 CAMDEN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151610",
            "telephone_number": "210-374-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 CAMDEN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151610",
            "telephone_number": "210-374-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWAO",
        "first_name": "KELLEAH",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1098367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.