TINA MCKELLERY (NPI# 1063869865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063869865 |
| Entity Type | Individual |
| Full Name | TINA MCKELLERY |
| Practice Address |
19932 Blackstone St Detroit MI 48219-1313 |
| Practice Telephone | 3135385170 |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2016-05-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247200000X | Technician, Other | MI | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
19932 BLACKSTONE ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48219-1313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396008 | Betty Jean Fairchild-el | Home Health Aide | 20018 Norhtrop, Detroit, MI 48219 | 2020-11-04 |
| 1134787633 | Behavioral Health Professionals, Inc | Family Medicine | 19750 Burt Road, Detroit, MI 48219 | 2019-05-31 |
| 1255997755 | Shvaughn Laniece Nunley | Social Worker | 18422 W Mcnichols Rd, Detroit, MI 48219 | 2019-05-10 |
| 1770081168 | D & D Enterprise Group LLC | Durable Medical Equipment & Medical Supplies | 17405 Lahser, 202, Detroit, MI 48219 | 2018-01-31 |
| 1972011369 | Fibers of The Family LLC | Home Health | 16800 Edinborough Rd, Detroit, MI 48219 | 2018-01-19 |
| 1871049684 | Monique Jackson | Occupational Therapist | 21630 Jessel Ave, Detroit, MI 48219 | 2016-08-31 |
| 1114379773 | Audrey Hopkins | Licensed Practical Nurse | 20277 Redfren, Detroit, MI 48219 | 2016-07-07 |
| 1649628785 | Erin Bianco | Social Worker | 17321 Telegraph Rd., Detroit, MI 48219 | 2016-05-31 |
| 1144674664 | Lucinda Galmon-wallace | Technician, Other | 24424 Telegraph Road, Detroit, MI 48219 | 2016-04-21 |
| 1598120925 | Faith's Place LLC | Psychiatric Residential Treatment Facility | 16725 Blackstone Street, Detroit, MI 48219 | 2015-12-30 |
| Find all providers in zip 48219 | ||||
| Taxonomy Code | 247200000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
| Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952889743 | Myesha Gibson Wilson | Technician, Other | 22457 Kendall St, Detroit, MI 48223-2542 | 2018-08-02 |
| 1871071647 | Deidre Flowers | Technician, Other | 6776 Stahelin Ave # 23, Detroit, MI 48228-3465 | 2018-08-02 |
| 1750828489 | Charneil Tuggle | Technician, Other | 19017 Pierson St, Detroit, MI 48219-2517 | 2017-01-19 |
| 1720523293 | Eno Esu | Technician, Other | 8136 Appoline St, Detroit, MI 48228-4002 | 2016-12-20 |
| 1710420195 | Cassandra Wells | Technician, Other | 11691 Beaverland, Detroit, MI 48239-1358 | 2016-12-02 |
| 1306389945 | Arnesha Bernice Jennings | Technician, Other | 19210 Robson St, Detroit, MI 48235-1949 | 2016-11-30 |
| 1962945444 | Diane Christiine Issa | Technician, Other | 5081 Garland St, Detroit, MI 48213-3366 | 2016-11-30 |
| 1164974358 | Xavier Robertson | Technician, Other | 18451 Northlawn St, Detroit, MI 48221-2019 | 2016-11-04 |
| 1518418631 | Luebertha Mcclellan | Technician, Other | 15346 Dexter Ave, Detroit, MI 48238-2127 | 2016-10-24 |
| 1558812891 | Tommie D Dotson | Technician, Other | 19360 Renfrew Rd, Detroit, MI 48221-1836 | 2016-10-21 |
| Find all providers in DETROIT | ||||
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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.