SIMPLY WELL BOUTIQUE MEDICINE
NPI 1740022730
Internal Medicine in New Braunfels, TX

Active since June 10, 2024CLIA 45D2301315 · Waiver
204 CAMP WILLOW RD, NEW BRAUNFELS, TX 78130(830) 620-7744(830) 625-0353 Get Directions Write a Review

NPPES record last updated: June 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 19, 2024, Jun 10, 2024 (2 updates tracked since 2024).

About Simply Well Boutique Medicine NPPES

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

SIMPLY WELL BOUTIQUE MEDICINE (NPI 1740022730) is a healthcare organization registered as an internal medicine in New Braunfels, Texas and active in the NPI registry since June 2024. The organization holds a CLIA Waiver certificate valid through March 24, 2028, maintains a secondary practice location in New Braunfels, and lists Teri Kelso, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1740022730
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKELLCY MEDICAL GROUP
Location Address204 CAMP WILLOW RDNew Braunfels, TX 78130-1805
Mailing Address204 Camp Willow RdNew Braunfels, TX 78130-1805 · (830) 620-7744 · Fax (830) 625-0353
Fax(830) 625-0353
Organization SubpartNo
Authorized OfficialTeri KelsoPractice Administrator · (830) 620-7744
Enumeration DateJune 10, 2024
Last NPPES UpdateJune 19, 20242 updates tracked since enumeration
NPPES CertifiedJune 18, 2024
NPI 1740022730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

204 CAMP WILLOW RD, New Braunfels, TX 78130

Other Names 1

Doing Business AsSimply Well Boutique Medicine

Secondary Practice Location 1

Location 1204 Camp Willow RdNew Braunfels, TX 78130-1805 · Phone (830) 620-7744 · Fax (830) 625-0353

Other Identifiers 1

Other1881813806TX · Group Npi

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

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 45D2301315

Kellcy Medical Group · New Braunfels, TX
Active · expires Mar 24, 2028
CLIA Number45D2301315
Laboratory TypePhysician Office
Certificate Effective DateMarch 25, 2026
Certificate Expiration DateMarch 24, 2028
Laboratory DirectorJulia R. Kellcy
Laboratory Phone(210) 365-7051
Laboratory LocationKellcy Medical Group204 Camp Willow Road, New Braunfels, TX 78130
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

Internal Medicine
204 CAMP WILLOW RD
NEW BRAUNFELS, TX 78130
Nurse Practitioner (Family)
204 CAMP WILLOW RD
NEW BRAUNFELS, TX 78130
Nurse Practitioner (Family)
204 CAMP WILLOW RD
NEW BRAUNFELS, TX 78130
Nurse Practitioner (Acute Care)
204 CAMP WILLOW RD
NEW BRAUNFELS, TX 78130
Internal Medicine
204 CAMP WILLOW RD
NEW BRAUNFELS, TX 78130

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 Kellcy Medical Group's NPI number?

The NPI number for Kellcy Medical Group is 1740022730. It was assigned to this organization in the NPPES registry on June 10, 2024. The provider is doing business as Simply Well Boutique Medicine.

Where is Kellcy Medical Group located?

Kellcy Medical Group is located at 204 Camp Willow Rd, New Braunfels, TX 78130. The listed phone number is (830) 620-7744.

What is Kellcy Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Kellcy Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2301315) is associated with this NPI, valid through March 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kellcy Medical Group was last updated on June 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.