KELLY HAUSENBAUER (NPI# 1053695304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053695304 |
| Entity Type | Individual |
| Full Name | KELLY HAUSENBAUER |
| Credential | P.A. |
| Practice Address |
310 W Ninth St Frederick MD 21701-4546 |
| Practice Telephone | 3016956800 |
| Practice Fax Number | 3016956891 |
| Mailing Telephone | 3016956800 |
| Mailing Fax Number | 3016956891 |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C0004612 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
310 W NINTH ST |
| City | FREDERICK |
| State | MD |
| Zip Code | 21701-4546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718504 | Sean Edward Hunt | Internal Medicine | 310 W Ninth St, Frederick, MD 21701-4546 | 2005-05-30 |
| 1538568365 | Nasim Adimi | Internal Medicine | 310 W Ninth St, Frederick, MD 21701-4546 | 2014-08-18 |
| 1669748141 | Natasha Kamal | Internal Medicine | 310 W Ninth St, Frederick, MD 21701-4546 | 2012-03-28 |
| 1235368994 | Janet M Dakers-bidle | Nurse Practitioner | 310 W Ninth St, Frederick, MD 21701-4546 | 2009-07-02 |
| 1780828392 | Colette L Benton | Nurse Practitioner | 310 W Ninth St, Frederick, MD 21701-4546 | 2009-04-27 |
| 1669620746 | Gordon Daniel Liss | Internal Medicine | 310 W Ninth St, Frederick, MD 21701-4546 | 2008-09-03 |
| 1316998883 | Ali J. Husain | Internal Medicine | 310 W Ninth St, Frederick, MD 21701-4546 | 2006-05-12 |
| 1508869827 | Matthew Thomas Yeatman | Internal Medicine | 310 W Ninth St, Frederick, MD 21701-4546 | 2005-05-31 |
| 1487657797 | Carolyn Joy Hedin | Nurse Practitioner | 310 W Ninth St, Frederick, MD 21701-4546 | 2005-05-31 |
| 1184627473 | Cardiology Center LLP | Internal Medicine | 310 W Ninth St, Frederick, MD 21701-4546 | 2005-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670045 | Alana Earp | Social Worker | 810 Toll House Avenue, Frederick, MD 21701 | 2019-10-14 |
| 1851866065 | Main Place Treatment Centers LLC. | Clinic/Center | 127 S. Smallwood Street, Frederick, MD 21701 | 2018-10-04 |
| 1649775933 | Old Fashion Medicine, Inc | Internal Medicine | 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 | 2018-03-28 |
| 1063917938 | Kristin Deely | Nurse Practitioner | 400 West 7th Street, Cardiac Cath Lab 2nd Floor, Frederick, MD 21701 | 2018-03-24 |
| 1689180119 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 300 B Scholls Lane, Frederick, MD 21701 | 2017-12-20 |
| 1326590068 | Natalie Reid | Nurse Practitioner | 9093 Ridgefield Dr Ste 104, Frederick, MD 21701 | 2016-10-28 |
| 1649727967 | Scl Corpration | In Home Supportive Care | 550 Highland Street, Suite 110, Frederick, MD 21701 | 2016-09-02 |
| 1891159661 | Wellave, LLC | Clinic/Center | 411 Aviation Way Ste 245, Frederick, MD 21701 | 2016-04-07 |
| 1144694969 | Leslee Bry | Counselor | 120 W Church St Ste 3b, Frederick, MD 21701 | 2015-11-17 |
| 1851797732 | Frederick Dental | Dentist | 401 W 7th Street, Frederick Dental, Frederick, MD 21701 | 2014-11-05 |
| Find all providers in zip 21701 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801164066 | Atekelt Yilma Tadese | Physician Assistant | 46-b Thomas Johnson Drive, Suite 200, Frederick, MD 21702 | 2011-12-02 |
| 1619121472 | Barbara S. Rebele | Physician Assistant | 22 S Market St, Suite 6d, Frederick, MD 21701-5570 | 2008-11-06 |
| 1790954253 | Robert Paul Cathor | Physician Assistant | 56 Thomas Johnson Drive, Ste 110, Frederick, MD 21702-4599 | 2008-02-28 |
| 1598946006 | Justina A Bennett | Physician Assistant | 85 Thomas Johnson Ct, Suite C, Internal Medicine Specialists of Frederick, Frederick, MD 21702 | 2007-11-27 |
| 1104809342 | Tara Carson Jernejcic | Physician Assistant | 100 South Market Street, Frederick Community Action Agency, Frederick, MD 21701 | 2005-11-22 |
| 1376001214 | Lewis Edel Bertus | Physician Assistant | 610 Solarex Ct, Frederick, MD 21703-8624 | 2019-03-11 |
| 1922510056 | Paola Haros | Physician Assistant | 196 Thomas Johnson Dr, Frederick, MD 21702-4397 | 2017-10-30 |
| 1861867459 | Kelly Murray | Physician Assistant | 915 Toll House Ave Ste 103, Frederick, MD 21701-5911 | 2015-12-08 |
| 1295142388 | Rebecca Alyson Leonard | Physician Assistant | 63 Thomas Johnson Dr, Suite E, Frederick, MD 21702-4384 | 2014-07-21 |
| 1912332123 | Brittany Leigh Henry | Physician Assistant | 87 Thomas Johnson Dr Ste 101, Frederick, MD 21702-4427 | 2013-09-06 |
| Find all providers in FREDERICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.