KELLY'S PRIMARY CARE, INC (NPI# 1083749824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083749824 |
| Entity Type | Organization |
| Organization Name | KELLY'S PRIMARY CARE, INC |
| Practice Address |
2009 N Conway Ave Mission TX 78572-2965 |
| Mailing Address |
2007 N Conway Ave Mission TX 78572 |
| Practice Telephone | 9565830141 |
| Practice Fax Number | 9565830143 |
| Mailing Telephone | 9565830141 |
| Mailing Fax Number | 9565830143 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2011-06-07 |
| Authorized Official Name | JAYNIE CHAPA (ADMINISTRATOR) |
| Authorized Official Telephone | 9565830141 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 006524 | TX | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 001012821 | 05 | |
| TX | 185365701 | 05 | |
| TX | 000017300 | 05 |
| Street Address |
2009 N CONWAY AVE |
| City | MISSION |
| State | TX |
| Zip Code | 78572-2965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619332863 | Crystal Domynique Martin | Counselor | 2009 N Conway Ave, Mission, TX 78572-2965 | 2015-12-15 |
| 1578935086 | Cortez & Associates Counseling Services, LLC | Counselor | 2009 N Conway Ave, Mission, TX 78572-2965 | 2015-10-22 |
| 1558739623 | Gladys Cortez | Counselor | 2009 N Conway Ave, Mission, TX 78572 | 2015-09-08 |
| 1033462023 | Cassandra Garza-juarez | Counselor | 2009 N Conway Ave, Mission, TX 78572-2965 | 2012-10-16 |
| 1124140181 | Delinda G. Britton | Counselor | 2009 N Conway Ave, Mission, TX 78572-2965 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676814 | Trinity Hospice Care, LLC. | Physical Therapist | 1713 W Griffin Pkwy., Ste. D, Mission, TX 78572 | 2020-07-22 |
| 1710528187 | Te Cuidamos, LLC | Home Health | 2205 N Inspiration Rd, Ste A, Mission, TX 78572 | 2019-10-07 |
| 1356806475 | Severo Esteban Saenz | Physical Therapist | 816 Travis St Apt E55, Mission, TX 78572 | 2019-02-02 |
| 1609352715 | Community First Home Health | Home Health | 1707 Merlin, Mission, TX 78572 | 2018-07-12 |
| 1831681279 | Yuriko Garcia | Physician Assistant | 910 S. Bryan Rd., Suite #105, Mission, TX 78572 | 2018-06-01 |
| 1982193918 | Dalinda Valdez | Registered Nurse | 1707 Merlin Dr, Mission, TX 78572 | 2018-05-04 |
| 1487152260 | Azul Homecare, LLC. | Technician | 2007 East Griffin Parkway, Ste. C, Mission, TX 78572 | 2018-01-26 |
| 1760998371 | J Bravo Medical Services | Clinic/Center | 2001 W 3 Mile Line Rd, 2400 & 2500, Mission, TX 78572 | 2017-12-18 |
| 1821528654 | Bit Na Lee | Dentist | 213 E Expy 83, Mission, TX 78572 | 2017-06-14 |
| 1568901957 | Ofelia Perez Hernandez Dds Pllc | Dentist | 8360 W. Expy 83, Mission, TX 78572 | 2017-02-17 |
| Find all providers in zip 78572 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083908610 | Resolutionscounseling&consultingservices,llc | Preferred Provider Organization | 5845 Horton St Ste 12, Mission, KS 66202-2653 | 2011-05-31 |
| 1831268135 | Wiggles Children's Rehab | Preferred Provider Organization | 2011 E Griffin Pkwy, Mission, TX 78572-3222 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841849494 | Face To Face Healthcare Services LLC | Preferred Provider Organization | 2616 S Loop W Ste 300, Houston, TX 77054-2672 | 2019-09-06 |
| 1700438827 | Cleveland Phillips Jr. | Preferred Provider Organization | 11146 Vance Jackson Rd Apt 3801, San Antonio, TX 78230-2563 | 2019-07-09 |
| 1154983492 | Cassandra Denese Mitchell | Preferred Provider Organization | 8319 Heights Vly, Converse, TX 78109-3503 | 2019-07-08 |
| 1083187223 | Chinese Community Center, Inc. | Preferred Provider Organization | 9800 Town Park Dr, Houston, TX 77036-2316 | 2019-01-10 |
| 1013422492 | Cicero L Sadler | Preferred Provider Organization | 4001 San Jacinto St, Houston, TX 77004-4021 | 2017-12-07 |
| 1528577483 | Mary Brown-jacobs | Preferred Provider Organization | 501 Canvas Ct, Crowley, TX 76036-4338 | 2017-09-22 |
| 1962931220 | Ai Community Services LLC | Preferred Provider Organization | 6928 Shoreway Dr, Grand Prairie, TX 75054 | 2017-06-08 |
| 1649706227 | Divine Integrity Allied Healthcare Services | Preferred Provider Organization | 4738 Bedford Ave, Midland, TX 79703-4535 | 2017-05-03 |
| 1255866950 | Guardian of Angels Community Living | Preferred Provider Organization | 12703 Jones Rd, 1115, Houston, TX 77070-4676 | 2017-05-01 |
| 1356874622 | Urban Line LLC | Preferred Provider Organization | 2500 Woodland Park Dr Apt C304, Houston, TX 77077-2278 | 2017-04-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KELLY'S PRIMARY CARE, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.