Kelly Janish, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

P0235 Issued in TX

Practice address

6101 Woodway Dr
Suite 230
Woodway, TX 76712-6111

Phone

(254) 537-6400

Fax

(254) 537-6401

NPI assigned

Jul 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.janish.1@9635.direct.athenahealth.com

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.

• Providence Health Alliance

  • Specialist
  • Waco, TX
  • NPI 1932210838
  Medicare reassignment NPD
• Providence Health Alliance

  • Rural Health Clinic/Center
  • Waco, TX
  • NPI 1336590462
  NPD
• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1942463062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18962",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "800-566-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 WOODWAY DR",
            "address_2": "SUITE 230",
            "city": "WOODWAY",
            "state": "TX",
            "postal_code": "767126111",
            "telephone_number": "254-537-6400",
            "fax_number": "254-537-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANISH",
        "first_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P0235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "084249401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285536301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00N59X",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TPI",
            "identifier": "1932210838",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Hughes-Vaughan
• Prentis Hyde, PT
• Immaculate Minds LLC
• Staci Marie Istre, M.S., CCC-SLP
• Amanda Beth Jackson, LPC ASSOCIATE
• Jessica Deann Jefferson
• Jessica Pryor Counseling Services, LLC
• Brianna M. Johnson, M.S., CF-SLP
• Carrie Ann Johnson, FNP-C
• Destiney Nichole Jones

• Pediatrics Physician in Woodway, TX
• Providers in Woodway, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.