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KELSOM CLINIC PA
NPI 1104840594
Family Medicine in Irving, TX

Active since July 27, 2006CLIA 45D0995230 · Waiver
1202 W PIONEER DR STE 100, IRVING, TX 75061(972) 254-7272(972) 254-7575 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Kelsom Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELSOM CLINIC PA (NPI 1104840594) is a healthcare organization registered as a family medicine in Irving, Texas and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through January 13, 2028, maintains a secondary practice location in Mesquite, and lists Catherine Okoronkwo, Md, as its authorized official.

NPPES Registry Identity

NPI1104840594
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKELSOM CLINIC PA
Location Address1202 W PIONEER DR STE 100Irving, TX 75061-7309
Mailing Address1202 W Pioneer Dr, Suite 100Irving, TX 75061-7308 · (972) 254-7272 · Fax (972) 254-7575
Phone(972) 254-7272
Fax(972) 254-7575
Organization SubpartYes
Authorized OfficialCatherine OkoronkwoMd · (972) 254-7272
Enumeration DateJuly 27, 2006
Last NPPES UpdateJanuary 20, 2026
NPPES CertifiedJanuary 20, 2026
✔ NPI 1104840594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · K2252
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1202 W PIONEER DR STE 100, Irving, TX 75061
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Secondary Practice Location 1

Location 13220 Gus Thomasson Rd Ste 113, SUITE 113Mesquite, TX 75150-4051 · Phone (972) 279-7373 · Fax (972) 254-7272

Other Identifiers 1

Medicaid160977801TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0995230

Kelsom Clinic Inc · Irving, TX
Active · expires Jan 13, 2028
CLIA Number45D0995230
Laboratory TypePhysician Office
Certificate Effective DateJanuary 14, 2026
Certificate Expiration DateJanuary 13, 2028
Laboratory DirectorCatherine N. Okoronkwo MD
Laboratory Phone(972) 254-7272
Laboratory LocationKelsom Clinic Inc1202 W Pioneer Drive, # 100, Irving, TX 75061
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GULZAR R PIRWANI NP
Internal Medicine
1202 W PIONEER DR STE 100
IRVING, TX 75061
Dallas County (972) 254-7272
JOY IHUOMA UTOKANANDU FNP-BC
Nurse Practitioner (Family)
1202 W PIONEER DR STE 100
IRVING, TX 75061
Dallas County (972) 254-7272
PATRICIA EMEFIELE FNP
Nurse Practitioner (Family)
1202 W PIONEER DR STE 100
IRVING, TX 75061
Dallas County (972) 254-7272

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsom Clinic PA's NPI number?

The NPI number for Kelsom Clinic PA is 1104840594. It was assigned to this organization in the NPPES registry on July 27, 2006.

Where is Kelsom Clinic PA located?

Kelsom Clinic PA is located at 1202 W Pioneer Dr Ste 100, Irving, TX 75061. The listed phone number is (972) 254-7272.

What is Kelsom Clinic PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Kelsom Clinic PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0995230) is associated with this NPI, valid through January 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kelsom Clinic PA accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 2 other insurers list Kelsom Clinic PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelsom Clinic PA was last updated on January 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.