KELLY CHRISTINE MERCER (NPI# 1154609790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154609790 |
| Entity Type | Individual |
| Full Name | KELLY CHRISTINE MERCER |
| Credential | PA-C, MPH |
| Practice Address |
4060 Fairmount Ave San Diego CA 92105-1608 |
| Practice Telephone | 6195841612 |
| Practice Fax Number | 6195782588 |
| Mailing Telephone | 6195841612 |
| Mailing Fax Number | 6195782588 |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2019-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA21625 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHYSICIAN ASSISTANT LICENSE | PA21625 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710190822 | Kelly Mercer | Home Health Aide | 117 Mendota St, Mansfield, OH 44903-2420 | 2007-05-07 |
| 1336408582 | Kelly Ross Mercer | Anesthesiology | 619 19th St S, Birmingham, AL 35249-1900 | 2012-05-09 |
| Street Address |
4060 FAIRMOUNT AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92105-1608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104981 | Sombath Senethong | Family Medicine | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2005-06-16 |
| 1811594286 | Nathanael Jonathan Luna | Pharmacist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2020-10-07 |
| 1184243420 | Soona Ko | Student in an Organized Health Care Education/Training Program | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2020-04-15 |
| 1780233098 | Cristina L Kim | Nurse Practitioner | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-09-09 |
| 1275189110 | Jessica Wilson | Nurse Practitioner | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-08-15 |
| 1073177739 | La Maestra Family Clinic, Inc. | Clinic/Center | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-04-29 |
| 1982181772 | Vahid Niki | Dentist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2018-07-24 |
| 1417446477 | Kellie Ramsey | Dentist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2018-05-05 |
| 1528586716 | Emilia Kodiath | Dentist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2017-09-07 |
| 1659814648 | Iran Felix | Nurse Practitioner | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2016-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934798 | Point Loma Nazarene University | Nurse Practitioner | Point Loma Nazarene University Health Promotion Center, 4101 University Avenue, San Diego, CA 92105 | 2019-10-23 |
| 1104478809 | Kristin Lynn Nichols | Counselor | 4823 El Cajon Blvd Suite #115, San Diego, CA 92105 | 2019-07-12 |
| 1205343076 | Momentum Learning | Counselor | 3720 El Cajon Blvd., Sd, CA 92105 | 2018-01-03 |
| 1306352695 | Nathan Hien Le, Dds. Inc | Dentist | 4170 Fairmount Ave., San Diego, CA 92105 | 2017-12-21 |
| 1073038071 | Aika Mary Erlandson | Student in an Organized Health Care Education/Training Program | 5296 University Ave. Suite F-2, San Diego, CA 92105 | 2017-08-10 |
| 1457872178 | Ride-in Transport LLC | Non-emergency Medical Transport (VAN) | 4061 Fairmount Ave, San Diego, CA 92105 | 2017-07-03 |
| 1598205346 | Ahmed Mooge | Ambulance | 4061 Fairmout Ave, San Diego, CA 92105 | 2017-02-27 |
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1730634098 | Med Specialty Sai Inc. | Pharmacy | 4153 University Avenue, Suite B, San Diego, CA 92105 | 2016-08-16 |
| 1568857464 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 | 2015-03-30 |
| Find all providers in zip 92105 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| 1639776503 | Nathan Tuan Dinh | Physician Assistant | 8296 Via Escalada, San Diego, CA 92129-2223 | 2020-10-05 |
| 1750988671 | Denise Aquino | Physician Assistant | 7322 Mesa College Dr Apt 7, San Diego, CA 92111-4943 | 2020-10-04 |
| 1962009183 | Courtney Krysl | Physician Assistant | 14434 Corte Lampara, San Diego, CA 92129-3818 | 2020-10-01 |
| 1497369284 | Brian Carroll | Physician Assistant | 7242 Melotte St, San Diego, CA 92119-1613 | 2020-08-31 |
| 1871104067 | Satoshi Ikeda | Physician Assistant | 16198 Paseo Del Sur, San Diego, CA 92127-6155 | 2020-08-12 |
| 1760009989 | Lili Tran | Physician Assistant | 8865 Calle Tragar, San Diego, CA 92129-2156 | 2020-07-03 |
| 1245857259 | Kendra Roberta Witt | Physician Assistant | 11396 Poblado Rd, San Diego, CA 92127-1351 | 2020-06-25 |
| 1336766344 | Brandon Scott Johnson | Physician Assistant | 1540 Oliver Ave Apt C, San Diego, CA 92109-5595 | 2020-06-25 |
| 1104441021 | Kira Ann Tellache | Physician Assistant | 4520 Executive Dr Ste 325, San Diego, CA 92121-3087 | 2020-06-16 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on KELLY CHRISTINE MERCER.
| 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.