MR. KELLY JOHN SKIPPER


Address: 4525 Gilbert Ave, #107, Dallas, TX 75219-2122
Phone: 2145295024

MR. KELLY JOHN SKIPPER (NPI# 1154654507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154654507
Entity Type Individual
Full Name MR. KELLY JOHN SKIPPER
Credential SURGICAL ASSISTANT
Practice Address 4525 Gilbert Ave
#107
Dallas
TX 75219-2122
Practice Telephone 2145295024
Mailing Telephone 2145295024
Enumeration Date 2009-09-16
Last Update Date 2009-09-16
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
09-262 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4525 GILBERT AVE
#107
City DALLAS
State TX
Zip Code 75219-2122

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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326691957 Kourtney Marie Willett Physician Assistant 1411 N Beckley Ave Pav 3 Suite 363, Dallas, TX 75203-1259 2019-07-23
1003302944 Amk Provider Solutions Pllc Physician Assistant 8197 Midtown Blvd Apt 15101, Dallas, TX 75231-4566 2018-07-03
1184136632 Pa Solutions, Pllc Physician Assistant 1408 N Riverfront Blvd # 166, Dallas, TX 75207-3912 2017-10-24
1528589918 Operator Assistants, LLC Physician Assistant 8440 Walnut Hill Ln Ste 250, Dallas, TX 75231-3815 2017-07-06
1447603683 Exos Surgical Assist, Pllc Physician Assistant 7324 Gaston Ave Ste 124-90, Dallas, TX 75214-6126 2016-07-22
1871941419 Premier Physician Surgical Associates, Pllc Physician Assistant 9540 Garland Rd # 381-416, Dallas, TX 75218-5004 2016-05-24
1144686452 Clara Joplin Physician Assistant 10830 N. Central Expy. Suite 120, Dallas, TX 75231-1050 2016-01-04
1689057820 Horizon Pa Services, Pllc Physician Assistant 381 Casa Linda Plz # 417, Dallas, TX 75218-3471 2015-07-07
1942681572 Ridgeback Assist, Pllc Physician Assistant 381 Casa Linda Plz # 418, Dallas, TX 75218-3471 2015-06-09
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City DALLAS
Zip Code 75219

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Dataset Information

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.

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