Kellcy Medical Group, P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K5088 Issued in TX

Legal business name

KELLCY MEDICAL GROUP, P.A.

Practice address

204 Camp Willow Rd
New Braunfels, TX 78130-1805

Phone

(830) 627-9208

Fax

(830) 625-0353

NPI assigned

Apr 25, 2007

Last updated

Jul 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martha Brandenburg

Title

Billing Admin

Phone

(830) 627-9208

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• DeHoyos Medical Group, P.A. Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julia R Kellcy, D.O.

  • Internal Medicine Physician
  • New Braunfels, TX
  • NPI 1265540793
  Medicare reassignment Care Compare group
• Sierra Joy Santellana, PA-C

  • Physician Assistant
  • Houston, TX
  • NPI 1245578046
  Medicare reassignment Care Compare group
• Holly Chapman, FNP

  • Family Nurse Practitioner
  • New Braunfels, TX
  • NPI 1730678103
  NPD
• Sarah Catherine Gaylord, FNP

  • Family Nurse Practitioner
  • Nashville, TN
  • NPI 1275639734
  NPD
• Anna Marie Boecker, MD

  • Pediatrics Physician
  • New Braunfels, TX
  • NPI 1912970187
  NPD (past)
• Lisa Rae Hanna, PA-C

  • Physician Assistant
  • College Station, TX
  • NPI 1821148214
  NPD (past)
• James P Murray Jr., MD

  • Internal Medicine Physician
  • Selma, TX
  • NPI 1154398980
  NPD (past)
• Danette Rai Elliott-Mullens, DO

  • Internal Medicine Physician
  • Bend, OR
  • NPI 1417977042
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1881813806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 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": "830-627-9208",
            "fax_number": "830-625-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLCY MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-07-30",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "BRANDENBURG",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "BILLING  ADMIN",
        "authorized_official_telephone_number": "830-627-9208"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K5088",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K5088",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143316101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeHoyos Medical Group, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Keeli Stumbo MD PA
• John Edward Kehoe, MD, MPH
• Morgan Kehrberg
• Kendra Deanne Keith, MS, RD, LD, CDCES
• Kellcy Medical Group (Simply Well Boutique Medicine)
• Julia R Kellcy, D.O.
• Todd Alan Keller, DDS, MS
• Karen Leigh Kelley, MS
• Abigail Kelling
• Cecily Hostrup Kelly, MD

• 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 Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.