MEDINA LAKE CLINIC PA
NPI 1811274525
Family Medicine in Lakehills, TX
About Medina Lake Clinic Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEDINA LAKE CLINIC PA (NPI 1811274525) is a healthcare organization registered as a family medicine in Lakehills, Texas and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through January 17, 2028 and lists Shelly Kohlleppel, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted 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 45D2035474
Medina Lake Clinic PA · Lakehills, TXOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PIPE CREEK, TX 78063
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 Medina Lake Clinic PA's NPI number?
The NPI number for Medina Lake Clinic PA is 1811274525. It was assigned to this organization in the NPPES registry on November 9, 2011.
Where is Medina Lake Clinic PA located?
Medina Lake Clinic PA is located at 146 Laurel Vista Dr, Lakehills, TX 78063. The listed phone number is (713) 292-6959.
What is Medina Lake Clinic PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Does Medina Lake Clinic PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2035474) is associated with this NPI, valid through January 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Medina Lake Clinic 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 list Medina Lake 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 Medina Lake Clinic PA was last updated on March 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.
# Medina Lake Clinic Pa · NPI 1811274525
Family Medicine organization in Lakehills, Texas. Organization record, active in the CMS NPPES registry since November 9, 2011.
## Identity
- **NPI:** 1811274525 (Entity type: Organization)
- **Enumerated:** November 9, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Shelly Kohlleppel, OWNER
## Practice location
- **Address:** 146 LAUREL VISTA DR, Lakehills, TX 78063-6389
- **Phone:** (713) 292-6959
## Record status
- **NPPES last updated:** March 13, 2012
- **Other identifiers:** Medicare PIN TXB143461 (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1811274525) · Data from the CMS NPPES public registry.