KELLY JO VINCENT (NPI# 1194190637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194190637 |
| Entity Type | Individual |
| Full Name | KELLY JO VINCENT |
| Credential | PA-C |
| Practice Address |
8854 W Emerald St Suite #102 Boise ID 83704-4844 |
| Practice Telephone | 2083234747 |
| Practice Fax Number | 2083234848 |
| Mailing Telephone | 2083234747 |
| Mailing Fax Number | 2083234848 |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA-1332 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053728865 | Kelly Vincent | Psychologist | 1440 Broadway, Suite 610, Oakland, CA 94612-2041 | 2014-07-14 |
| Street Address |
8854 W EMERALD ST SUITE #102 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-4844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720081060 | Thomas Michael Chopp | Orthopaedic Surgery | 8854 W Emerald St, Ste 102, Boise, ID 83704-4844 | 2005-05-31 |
| 1336311224 | Idaho Crh Surgeons PC | Surgery | 8854 W Emerald St, Suite 140, Boise, ID 83704-4844 | 2008-03-31 |
| 1083885156 | A George Munayirji Md | Surgery | 8854 W Emerald St, Boise, ID 83704-4844 | 2008-03-17 |
| 1821143249 | Kevin M Saul | Physical Therapist | 8854 W Emerald St, Suite 280, Boise, ID 83704-4844 | 2007-01-24 |
| 1184779514 | Physical Therapy Centers of Idaho | Clinic/Center | 8854 W Emerald St, Suite 280, Boise, ID 83704-4844 | 2007-01-24 |
| 1821164138 | The Shoulder Clinic of Idaho Pllc | Orthopaedic Surgery | 8854 W Emerald St, Ste 102, Boise, ID 83704-4844 | 2006-11-28 |
| 1457363970 | Kathryn A Colson | Physician Assistant | 8854 W Emerald St, Ste 102, Boise, ID 83704-4844 | 2006-08-13 |
| 1649208851 | Thomas Earl Goodwin | Orthopaedic Surgery | 8854 W Emerald St, Suite 102, Boise, ID 83704-4844 | 2006-06-28 |
| 1083654305 | Troy B Watkins Jr. | Orthopaedic Surgery | 8854 W Emerald St, # 170, Boise, ID 83704-4844 | 2006-06-07 |
| 1023068194 | Jeffrey Glenn Hessing | Orthopaedic Surgery | 8854 W Emerald St, Suite 140, Boise, ID 83704-4844 | 2006-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| 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 |
|---|---|---|---|---|
| 1821695792 | Chelsea Dylan Tennent | Physician Assistant | 1666 E Gentlewind St, Boise, ID 83706-5914 | 2020-10-05 |
| 1871114553 | Samantha Tess Goodrich | Physician Assistant | 721 E Lenz St, Boise, ID 83712-7846 | 2020-05-04 |
| 1689131005 | Aftin Jade Martens | Physician Assistant | 303 N Allumbaugh St, Boise, ID 83704-9208 | 2019-02-21 |
| 1215418140 | Michael Edward Molnar | Physician Assistant | 2012 S Longmont Ave, Boise, ID 83706-4235 | 2018-08-28 |
| 1578059143 | Mckenzie Hart | Physician Assistant | 4334 S Aleut Way, Boise, ID 83709-6033 | 2018-07-07 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1073040242 | Nicole Ankenbrandt | Physician Assistant | 3151 S Terra Dr, Boise, ID 83709-3831 | 2017-05-17 |
| 1346792033 | Samantha Rae Lange | Physician Assistant | 1072 N Liberty St Ste 203, Boise, ID 83704 | 2016-10-27 |
| 1174070098 | Alexandra W Clapp | Physician Assistant | 6140 West Curtisian Avenue Suite 200, Boise, ID 83704 | 2016-09-08 |
| 1376914838 | Morgan Grace Roskelley | Physician Assistant | 703 S. Americana Blvd, Ste 120, Boise, ID 83702 | 2015-10-09 |
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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.