DR. KELLI RAYNELL FAVATA (NPI# 1184822348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184822348 |
| Entity Type | Individual |
| Full Name | DR. KELLI RAYNELL FAVATA |
| Credential | M.D. |
| Practice Address |
606 N Country Club Dr 5 Mesa AZ 85201-5700 |
| Mailing Address |
1343 N Alma School Rd 160 Chandler AZ 85224-5941 |
| Practice Telephone | 4807762982 |
| Practice Fax Number | 4807260695 |
| Mailing Telephone | 4809631853 |
| Mailing Fax Number | 4809631854 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2013-02-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 30177 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
606 N COUNTRY CLUB DR 5 |
| City | MESA |
| State | AZ |
| Zip Code | 85201-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275544322 | Merlyn Dean Smith | Family Medicine | 606 N Country Club Dr, #1 Clinic of Physicians and Surgeons, Mesa, AZ 85201-5700 | 2006-08-11 |
| 1225588163 | Mary Scott | Nurse Practitioner | 606 N Country Club Dr, Suite 5, Mesa, AZ 85201-5700 | 2016-10-04 |
| 1447588421 | Modern Diagnostic Imaging, P.C. | Radiology | 606 N Country Club Dr, Mesa, AZ 85201-5700 | 2009-12-02 |
| 1841473857 | Clinic of Physicians and Surgeons | Family Medicine | 606 N Country Club Dr, Ste 1, Mesa, AZ 85201-5700 | 2007-12-12 |
| 1063603470 | Mesa Clinic of Physicians and Surgeons, Pllc. | Family Medicine | 606 N Country Club Dr, #1, Mesa, AZ 85201 | 2007-08-09 |
| 1992716047 | Richard L Smith | Family Medicine | 606 N Country Club Dr, #1 Clinic of Physicians and Surgeons, Mesa, AZ 85201 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174141980 | Arch Hospice, LLC. | Hospice Care, Community Based | 1209 N. Country Club Dr., Ste. 1, Mesa, AZ 85201 | 2020-07-08 |
| 1861025876 | Summit Bhc Mesa LLC | Clinic/Center | 846 North Center Street Suite 101, Mesa, AZ 85201 | 2020-02-18 |
| 1427600774 | Coleen Chatter | Counselor | 711 N. Evergreenrd. Apt#2088, Mesa, AZ 85201 | 2019-07-16 |
| 1013487800 | Akos Live | Family Medicine | 1902 W. Main Street, Mesa, AZ 85201 | 2018-12-05 |
| 1760990329 | Sage Counseling, Inc. | Community/Behavioral Health | 460 N. Mesa Drive, Suites 207 and 209, Mesa, AZ 85201 | 2018-01-17 |
| 1336590025 | Horizon Health and Wellness, Inc. | Assisted Living Facility | 453 West Sunset Circle, Mesa, AZ 85201 | 2016-06-24 |
| 1356711279 | Cheryl Agosto | Registered Nurse | 1025 N. Country Club Dr, Mesa, AZ 85201 | 2015-10-05 |
| 1861877961 | Richard Roble | Speech-Language Pathologist | 125 N. Country Club Dr., Mesa, AZ 85201 | 2015-07-30 |
| 1326440991 | Demetria Harris | Counselor | 455 N. Mesa Drive #11, Mesa, AZ 85201 | 2014-09-25 |
| 1588002489 | Zhen Liu | Acupuncturist | 210n. Center St, #102, Mesa, AZ 85201 | 2013-06-13 |
| Find all providers in zip 85201 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467914853 | Endeavor Mobile Medical, LLC | Internal Medicine | 6242 E Arbor Ave Ste 111, Mesa, AZ 85206-1309 | 2019-04-03 |
| 1851886329 | Alfonso A Tan Md PC | Internal Medicine | 6844 E Brown Rd Ste 101, Mesa, AZ 85207-3758 | 2018-06-27 |
| 1518450568 | Mhb Services | Internal Medicine | 1301 S Crismon Road, Mesa, AZ 85209 | 2018-06-13 |
| 1952849945 | Platinum Internal Medicine | Internal Medicine | 130 S 63rd St Ste 101, Mesa, AZ 85206-1620 | 2017-02-09 |
| 1700235751 | Iora Senior Health Inc | Internal Medicine | 9124 E Main St, Suite 20-21, Mesa, AZ 85207-8700 | 2016-06-10 |
| 1265811418 | Sandra Violetta Mele | Internal Medicine | 1301 S. Crimson Rd, Mesa, AZ 85209-3316 | 2015-05-20 |
| 1619312899 | Fiza Naueed Khan | Internal Medicine | 1400 South Dobson Road, Attn: Bmg Hospitalists Team/amanda Gump, Mesa, AZ 85202 | 2013-05-01 |
| 1760778906 | Maaz Iqbal | Internal Medicine | 535 E Mckellips Rd Ste 121, Mesa, AZ 85203-2527 | 2011-06-27 |
| 1326333733 | Amy Elizabeth Daliman | Internal Medicine | 6116 East Arbor Avenue, Suite 112, Mesa, AZ 85206 | 2011-06-14 |
| 1396046413 | Lifecare Hospitalists Pllc | Internal Medicine | 2627 N Raven, Mesa, AZ 85207-2038 | 2010-11-04 |
| Find all providers in MESA | ||||
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| 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.