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KELLUM MEDICAL GROUP, PA
NPI 1508813494
Family Medicine in San Antonio, TX

Active since May 27, 2006CLIA 45D0671939 · Waiver
7323 MARBACH RD STE 104, SAN ANTONIO, TX 78227(210) 674-0257(210) 369-9064 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 9, 2026, Sep 11, 2025, Aug 15, 2024 and 11 more (14 updates tracked since 2019).

About Kellum Medical Group, Pa NPPES

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

KELLUM MEDICAL GROUP, PA (NPI 1508813494) is a healthcare organization registered as a family medicine in San Antonio, Texas and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through October 2, 2026 and lists Kristi Braker, Contract Management, as its authorized official.

NPPES Registry Identity

NPI1508813494
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKELLUM MEDICAL GROUP, PA
Location Address7323 MARBACH RD STE 104San Antonio, TX 78227-1905
Mailing Address7323 Marbach Rd Ste 104San Antonio, TX 78227-1905 · (210) 674-0257 · Fax (210) 369-9064
Phone(210) 674-0257
Fax(210) 369-9064
Organization SubpartNo
Authorized OfficialKristi BrakerContract Management · (210) 674-0257
Enumeration DateMay 27, 2006
Last NPPES UpdateMarch 9, 202614 updates tracked since enumeration
NPPES CertifiedMarch 9, 2026
✔ NPI 1508813494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.

Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
7323 MARBACH RD STE 104, San Antonio, TX 78227
Open in Google Maps ↗

Other Identifiers 13

Other45D1026258TX · Clia - Kellum Medical Group, Pa - Pediatrics
Other1174518625TX · Daniel H Kellum Sr., Do - Npi
OtherCH6982TX · Medicare Rr Group Ptan#
Other1265413264TX · Alice T. Blackmon, Np-c / Npi#
Other1588641377TX · Salvador Vazquez, Md / Npi#
Other193200000XTX · Group Taxonomy
Other1346646510TX · Matthew Arismendez, Pa-c / Npi#
OtherR-14400TX · Radiology & X-ray Cert#
Other00295NTX · Medicare Group Ptan#
Other1063070308TX · Manuela Berry, Np-c / Npi#
Other45D0671939TX · Clia - Kellum Medical Group, Pa
Other1366623639TX · Kimberly 'kim' Diaz, Pa-c
Medicaid1508813494TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 45D0671939

Kellum Medical Group, PA · San Antonio, TX
Active · expires Oct 2, 2026
CLIA Number45D0671939
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2024
Certificate Expiration DateOctober 2, 2026
Laboratory DirectorDaniel Kellum Sr
Laboratory Phone(210) 674-0257
Laboratory LocationKellum Medical Group, PA7323 Marbach Rd #104, San Antonio, TX 78227
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

DANIEL H KELLUM SR. DO
Family Medicine
7323 MARBACH RD STE 104
SAN ANTONIO, TX 78227
Bexar County (210) 674-0257
ALICE T BLACKMON PNP-C
Nurse Practitioner (Pediatrics)
7323 MARBACH RD STE 104
SAN ANTONIO, TX 78227
Bexar County (210) 645-4305
KIMBERLY I DIAZ PA-C
Physician Assistant (Medical)
7323 MARBACH RD STE 104
SAN ANTONIO, TX 78227
Bexar County (210) 674-0257
DENISE KELLUM PA-C
Physician Assistant
7323 MARBACH RD STE 104
SAN ANTONIO, TX 78227
Bexar County (210) 231-2586
DR. SALVADOR C VAZQUEZ MD
Family Medicine
7323 MARBACH RD STE 104
SAN ANTONIO, TX 78227
Bexar County (210) 674-0257
JEANETTE CRENSHAW MSN, APRN, FNP-BC
Nurse Practitioner (Family)
7323 MARBACH RD STE 104
SAN ANTONIO, TX 78227
Bexar County (832) 870-0378
CYNTHIA PADILLA LAFUENTE FNP-C
Nurse Practitioner (Family)
7323 MARBACH RD STE 104
SAN ANTONIO, TX 78227
Bexar County (210) 674-0257

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 Kellum Medical Group, PA's NPI number?

The NPI number for Kellum Medical Group, PA is 1508813494. It was assigned to this organization in the NPPES registry on May 27, 2006.

Where is Kellum Medical Group, PA located?

Kellum Medical Group, PA is located at 7323 Marbach Rd Ste 104, San Antonio, TX 78227. The listed phone number is (210) 674-0257.

What is Kellum Medical Group, PA's specialty?

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

Does Kellum Medical Group, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0671939) is associated with this NPI, valid through October 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kellum Medical Group, PA accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Kellum Medical Group, 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 Kellum Medical Group, PA was last updated on March 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.