KELLY S KIAH (NPI# 1083055016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083055016 |
| Entity Type | Individual |
| Full Name | KELLY S KIAH |
| Credential | D.N.P. |
| Practice Address |
3800 Woodbriar Trl Port Orange FL 32129-9626 |
| Practice Telephone | 3863224752 |
| Mailing Telephone | 3863224752 |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2014-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP 9180473 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3800 WOODBRIAR TRL |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-9626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154409431 | Raul L Zimmerman | Family Medicine | 3800 Woodbriar Trl, Port Orange, FL 32129-9626 | 2006-11-02 |
| 1982812905 | John Bunnell | Family Medicine | 3800 Woodbriar Trl, Port Orange, FL 32129-9626 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025054 | Jessica Kate Hamilton | Nurse Practitioner | 3873 Long Grove Ln, Port Orange, FL 32129-8634 | 2020-08-28 |
| 1053929190 | Jay William Butwinick | Nurse Practitioner | 5357 Coquina Shores Ln, Port Orange, FL 32128-3011 | 2020-07-15 |
| 1275168999 | Robert Mathis | Nurse Practitioner | 930 Bentwood Ln, Port Orange, FL 32127-4814 | 2020-03-04 |
| 1417595646 | Kimberly Clough | Nurse Practitioner | 6147 Half Moon Dr, Port Orange, FL 32127-1128 | 2019-12-18 |
| 1104391465 | Jessica Kailee White | Nurse Practitioner | 5331 Cordgrass Bend Ln, Port Orange, FL 32128-3000 | 2018-10-12 |
| 1548745060 | Arsheema Abdurahman | Nurse Practitioner | 1690 Dunlawton Ave Ste 220, Port Orange, FL 32127-8980 | 2018-10-01 |
| 1366922882 | Stacey L Shaw | Nurse Practitioner | 1690 Dunlawton Ave Ste 230, Port Orange, FL 32127-8980 | 2018-08-14 |
| 1225516461 | Jessica Cole | Nurse Practitioner | 5400 S Williamson Blvd Apt 4-106, Port Orange, FL 32128-6540 | 2018-07-31 |
| 1457892226 | Jeannetta Ann Brooks | Nurse Practitioner | 3641 Clyde Morris Blvd Ste 400, Port Orange, FL 32129-2357 | 2017-03-13 |
| 1326159500 | Priscilla Clara Miller | Nurse Practitioner | 7800 Woodbriar Trail, Port Orange, FL 32129 | 2006-08-31 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
Please comment or provide details below to improve the information on KELLY S KIAH.
| 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.