DR. KELLY MAXWELL (NPI# 1083802565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083802565 |
| Entity Type | Individual |
| Full Name | DR. KELLY MAXWELL |
| Credential | PHARMD |
| Practice Address |
1500 N Westwood Blvd Poplar Bluff MO 63901-3318 |
| Practice Telephone | 5736864151 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2019-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PH-2009 | HI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942855416 | Kelly Maxwell | Physical Therapy Assistant | 6351 S Desert Blvd Bldg C, El Paso, TX 79932-1219 | 2019-08-01 |
| 1730687328 | Kelly Maxwell | Nurse Practitioner | 700 E University Ave, Des Moines, IA 50316-2302 | 2018-01-29 |
| 1295032142 | Kelly Jo Maxwell | Physical Therapy Assistant | 3041 Charlevoix Dr Se, Grand Rapids, MI 49546-7035 | 2011-02-11 |
| 1861727109 | Kelly Ann Maxwell | Counselor | 9378 Olive Blvd, Ste. 317, Saint Louis, MO 63132-3215 | 2009-10-05 |
| 1528216108 | Kelly Marie Maxwell | Urology | 676 N Saint Clair St, Suite 1835, Chicago, IL 60611-2927 | 2008-09-08 |
| 1972651669 | Kelly A Maxwell | Nurse Practitioner | 7125 Saltsburg Rd, Pittsburgh, PA 15235-2252 | 2007-01-08 |
| Street Address |
1500 N WESTWOOD BLVD |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-3318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142256 | Jeffrey Lee Dakas | Internal Medicine | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2005-05-24 |
| 1184244493 | Kristy Michelle Keirsey | Dental Hygienist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2020-04-16 |
| 1538788310 | Wendy Lynn Weston | Nurse Practitioner | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2020-04-13 |
| 1841842713 | Lyrra Suszanne Stucker | Registered Nurse | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2019-07-11 |
| 1043874803 | Deirdre Stocks | Nurse Practitioner | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2019-04-26 |
| 1053892026 | Janet Lee Turner | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2018-08-27 |
| 1215450291 | Richard Ladka | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2017-07-20 |
| 1285157388 | Jessica Lynn Libla | Nurse Practitioner | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2017-07-20 |
| 1780107995 | Hannah Irene Terry | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901 | 2017-07-19 |
| 1780112953 | Lyntoria Rochelle Williams | Social Worker | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2017-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982045787 | Adam Michael Ivie | Pharmacist | 3240 Sky Line Dr, Poplar Bluff, MO 63901-2088 | 2013-07-10 |
| 1992241558 | Yolanda Myers | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2017-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1538647250 | Brian D Davis | Pharmacist | 600 Winding Oaks Pl, Ballwin, MO 63021-7379 | 2018-08-03 |
| 1144718313 | Eddy Airiohuodion | Pharmacist | 8629 E Utopia Pkwy Apt 11, Raytown, MO 64138-5307 | 2018-04-24 |
| 1770085987 | Brigid Farrar | Pharmacist | 440 E Tampa St # 100, Springfield, MO 65806-1131 | 2018-03-03 |
| 1104347277 | Blake William Baumann | Pharmacist | 2301 Homes St, Kansas City, MO 64108 | 2017-06-29 |
| 1497280523 | Scott Strassels | Pharmacist | 8002 Davis Dr, Clayton, MO 63105-2529 | 2017-04-26 |
| 1942682604 | Shane Austin | Pharmacist | 8660 Old Bonhomme Rd Apt B, Saint Louis, MO 63132-3936 | 2015-06-18 |
| 1255735015 | Surendra R Patel | Pharmacist | 333 Solar Terrace Ct, Chesterfield, MO 63017-2499 | 2014-10-22 |
| 1093131500 | Chessa Nyberg | Pharmacist | 410 E Porte Cimi Pas St, Kansas City, MO 64131-2922 | 2014-03-07 |
| 1063833127 | Brent Tackitt | Pharmacist | 1768 Winding Glen Dr, Saint Charles, MO 63303-5099 | 2013-12-16 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
Please comment or provide details below to improve the information on DR. KELLY MAXWELL.
| 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.