THEODORE KELLEY (NPI# 1154520823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154520823 |
| Entity Type | Individual |
| Full Name | THEODORE KELLEY |
| Credential | MD |
| Practice Address |
12925 Highway 601 Ste 300 Midland NC 28107-9535 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7048883702 |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2020-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2009-00823 | NC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10030 Edison Square Dr Nw, Ste 100, Concord, NC 280278308 | 7044037830 |
| Street Address |
12925 HIGHWAY 601 STE 300 |
| City | MIDLAND |
| State | NC |
| Zip Code | 28107-9535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760452676 | Edith Elaine Cloud | Family Medicine | 12925 Highway 601, Midland Family Medicine, Midland, NC 28107-9536 | 2006-01-24 |
| 1225522949 | Luckhardt, Pllc | Clinic/Center | 12925 Highway 601, Midland, NC 28107 | 2018-06-16 |
| 1760856918 | Matthew L. Hubis Dmd, Pa | Dentist | 12925 Highway 601, Suite 200, Midland, NC 28107-9535 | 2015-11-25 |
| 1972986321 | Diana L Millard | Dentist | 12925 Highway 601, Midland, NC 28107 | 2015-07-02 |
| 1659789105 | Stacy Fernandez | Nurse Practitioner | 12925 Highway 601, Ste 300, Midland, NC 28107-9535 | 2014-07-29 |
| 1265869846 | The Charlotte-mecklenburg Hospital Authority | Family Medicine | 12925 Highway 601, Ste 300, Midland, NC 28107-9535 | 2013-09-27 |
| 1316214489 | Nicole Deschenes | Nurse Practitioner | 12925 Highway 601, Suite 300, Midland, NC 28107-9535 | 2011-11-17 |
| 1588861843 | Meredith Bowen | Family Medicine | 12925 Highway 601, Ste 300, Midland, NC 28107-9535 | 2007-06-29 |
| 1447324777 | Eyeoptix Od, Pa | Optometrist | 12925 Highway 601, Midland, NC 28107-9535 | 2006-11-20 |
| 1073560850 | Carolinas Medical Center-northeast | Family Medicine | 12925 Highway 601, Suite 300, Midland, NC 28107-9535 | 2006-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649889965 | Jess P West Jr. | Dentist | 12180 Us-601 South, Midland, NC 28107 | 2020-07-23 |
| 1487841250 | Crawley Memorial Hospital Inc. | Skilled Nursing Facility | 315 West College Ave, Boiling Springs, NC 28107 | 2007-09-26 |
| 1912943192 | Amie L Howe | Pharmacist | 12925 Hwy 601 South, Midland, NC 28107 | 2006-06-22 |
| 1437470739 | Janice B Furr | Occupational Therapy Assistant | 8670 Hwy. 200 North, Midland, NC 28107-0000 | 2010-06-21 |
| 1518197623 | Rha Howell Care Center | Respite Care | 11955 Howell Center Drive, Midland, NC 28107-0000 | 2009-07-23 |
| 1487197547 | Katherine Moore Henriques Fernandez | Occupational Therapist | 601 Small Country Ln, Midland, NC 28107-7239 | 2016-11-22 |
| 1063918027 | Jeannie Legate | Occupational Therapy Assistant | 601 Small Country Ln, Midland, NC 28107-7239 | 2018-03-30 |
| 1306342365 | Gabrielle Grubic | Occupational Therapy Assistant | 601 Small Country Ln, Midland, NC 28107-7239 | 2018-03-30 |
| 1770088791 | Jordan Holt | Occupational Therapy Assistant | 601 Small Country Ln, Midland, NC 28107-7239 | 2018-03-30 |
| 1831525740 | Easter Seals Ucp North Carolina & Viriginia | Community Based Residential Treatment Facility, Mental Illness | 4293 Highway 24 27 E Ste A, Ste A, Midland, NC 28107-8500 | 2013-09-24 |
| Find all providers in zip 28107 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073599 | Julie Suzanne Rodriguez | Family Medicine | 421 W Wadley Ave Ste B, Midland, TX 79705-5368 | 2020-11-06 |
| 1982202263 | Stonehaven Medical Group, Pllc | Family Medicine | 4507 Santa Rosa Dr, Midland, TX 79707-2260 | 2020-10-09 |
| 1346888625 | Kw Medical Pllc | Family Medicine | 2300 W Michigan Ave Ste 7, Midland, TX 79701-5808 | 2019-12-17 |
| 1740827724 | Timothy W Holden | Family Medicine | 4005 Orchard Dr Midland, Midland, MI 48670-0001 | 2019-12-09 |
| 1609436062 | Rostam Adult and Pediatric Medicine Midland Pllc | Family Medicine | 801 Joe Mann Blvd, Suite H, Midland, MI 48642 | 2019-06-18 |
| 1104351055 | Mh Health Care Services, PC | Family Medicine | 2201 Fm 715, C/o Endeavor Family Clinic, Midland, TX 79706-4211 | 2017-04-28 |
| 1407380660 | Bel Esc Wellness Pllc | Family Medicine | 2304 W Michigan Ave Ste A, Midland, TX 79701-5830 | 2017-04-14 |
| 1588078620 | Melissa Weckesser | Family Medicine | 4611 Campus Ridge, Midland, MI 48670-6122 | 2014-06-17 |
| 1619388774 | Zachary Paul Castle | Family Medicine | 3415 N Loop 250 W Bldg 4, Midland, TX 79707-6034 | 2014-05-12 |
| 1447598875 | Bhuvana Balasekaran Md Pa | Family Medicine | 1301 W Wall St, Ste C, Midland, TX 79701-6621 | 2013-01-18 |
| Find all providers in MIDLAND | ||||
Please comment or provide details below to improve the information on THEODORE KELLEY.
| 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.