Active NPI
Conroe-Woodlands Gastroenterology, P.a.
- Gastroenterology Physician
- Conroe, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- CONROE-WOODLANDS GASTROENTEROLOGY, P.A.
- Practice address
- 1020 Riverwood CT Ste 300
Conroe, TX 77304-2974 - Phone
- (936) 760-1900
- Fax
- (936) 441-1907
- NPI assigned
- Feb 27, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Stephen Michael Kelly, MD
- Title
- President
- Phone
- (936) 760-1900
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
1020 Riverwood CT Ste 300
Conroe, TX 77304-2974
Mailing address
1020 Riverwood CT Ste 300
Conroe, TX 77304-2974
Phone (936) 760-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1729485 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0943120 | Conroe-Woodlands Gastroenterology | Certificate of waiver | Mar 12, 2027 |
| 45D2327769 | Conroe-Woodlands Gastroenterology, PA | Registration | Jul 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
1020 Riverwood Ct
Ste 300
Conroe, TX 77304
Phone (936) 760-1900
1501 River Pointe Dr
Ste 260
Conroe, TX 77304
Phone (936) 494-3003
1501 River Pointe Dr
Ste 240
Conroe, TX 77304
Phone (936) 494-3003
Practitioners & affiliated clinicians
Practitioners 16
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Conroe, TX
- NPI 1245367663
-
- Anatomic Pathology Physician
- Carrollton, TX
- NPI 1427034495
-
- Clinical Social Worker
- San Antonio, TX
- NPI 1952912776
-
- Nephrology Physician
- Houston, TX
- NPI 1003834904
-
- Registered Nurse
- Conroe, TX
- NPI 1942068408
-
- Family Nurse Practitioner
- Shenandoah, TX
- NPI 1710521422
-
- Nephrology Physician
- The Woodlands, TX
- NPI 1215124417
-
- Internal Medicine Physician
- Houston, TX
- NPI 1710125604
-
- Gerontology Nurse Practitioner
- Shenandoah, TX
- NPI 1578390209
-
- Mental Health Counselor
- San Antonio, TX
- NPI 1891105391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693267200000",
"number": "1962539155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 RIVERWOOD CT STE 300",
"city": "CONROE",
"state": "TX",
"postal_code": "773042974",
"telephone_number": "936-760-1900",
"fax_number": "936-441-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 RIVERWOOD CT STE 300",
"city": "CONROE",
"state": "TX",
"postal_code": "773042974",
"telephone_number": "936-760-1900",
"fax_number": "936-441-1907"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONROE-WOODLANDS GASTROENTEROLOGY, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-27",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A",
"authorized_official_last_name": "KELLY",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "936-760-1900",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1729485",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.