KELLI K WHITAKER PA
NPI 1902896855
Physician Assistant - Medical in Houston, TX

Q: What is Kelli Whitaker's NPI number?

The NPI number for Kelli Whitaker is 1902896855. It was assigned to this individual provider in the NPPES registry on October 24, 2005.

Q: What is Kelli Whitaker's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kelli Whitaker was last updated on January 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since October 24, 2005PECOS Enrolled

6621 FANNIN ST, HOUSTON, TX 77030(225) 939-4437 Get Directions Write a Review

NPPES record last updated: January 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Kelli K Whitaker Pa NPPES

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

KELLI K WHITAKER PA (NPI 1902896855) is an individual medical provider in Houston, Texas, licensed in Texas (PA12104) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902896855

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKELLI K WHITAKERCredential: PA

Location Address6621 FANNIN STHouston, TX 77030-2358

Mailing Address9118 Bluebonnet Centre BlvdBaton Rouge, LA 70809-2993 · (225) 368-2347 · Fax (225) 368-2280

Phone(225) 939-4437

Sole ProprietorNo

Enumeration DateOctober 24, 2005

Last NPPES UpdateJanuary 23, 2020

✔ NPI 1902896855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in TX · PA12104✔ Licensed in LA · A10195

6621 FANNIN ST, Houston, TX 77030

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Other Identifiers 1

Medicaid1625868LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelli K Whitaker Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

DR. TAKETO BABA M.D.

Pediatrics (Pediatric Emergency Medicine)