TAMMY BOYETTE KELLY (NPI# 1215267349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215267349 |
| Entity Type | Individual |
| Full Name | TAMMY BOYETTE KELLY |
| Other Name | TAMMY RAYE BOYETTE |
| Credential | PA-C |
| Practice Address |
7051 Alvarado Rd La Mesa CA 91942-8901 |
| Practice Telephone | 6194607775 |
| Mailing Telephone | 6194607775 |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2018-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA54682 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9107316 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
0110003655 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-02138 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS OF FL | Y0J7G | 01 |
| FL | 009498400 | 05 | |
| TRICARE/HEALTHNET | 1215267349 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 222 E Plaza Blvd, National City, CA 919503342 | 6194748989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376190280 | Tammy Kelly | Specialist | 7070 Dorn Spur Rd, Boonville, NY 13309-4000 | 2019-08-26 |
| 1346629730 | Tammy Jean Kelly | Massage Therapist | 1300 Columbia St Apt 206, Vancouver, WA 98660-2939 | 2015-05-19 |
| 1710986997 | Tammy Rose Kelly | Obstetrics & Gynecology | 6850 N Durango Dr, Ste 310, Las Vegas, NV 89149-4595 | 2005-07-19 |
| 1386032522 | Tammy Kelly | Registered Nurse | 424 Savannah Rd, Lewes, DE 19958-1462 | 2014-12-22 |
| Street Address |
7051 ALVARADO RD |
| City | LA MESA |
| State | CA |
| Zip Code | 91942-8901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477525657 | Michael Henry Verdolin | Anesthesiology | 7051 Alvarado Rd, Suite 101, La Mesa, CA 91942-8901 | 2006-02-02 |
| 1700258597 | Verdolin Medicolegal Consulting Inc. | Anesthesiology | 7051 Alvarado Rd, 101, La Mesa, CA 91942-8901 | 2015-10-20 |
| 1184009722 | Encompass Private Clinic | Family Medicine | 7051 Alvarado Rd, La Mesa, CA 91942-8901 | 2015-07-24 |
| 1386033371 | Encompass Private Clinic | Point of Service | 7051 Alvarado Rd, Suite 101, La Mesa, CA 91942-8901 | 2015-01-14 |
| 1033449640 | Encompass Family and Internal Medicine Group Inc | Family Medicine | 7051 Alvarado Rd, 201, La Mesa, CA 91942-8901 | 2010-01-04 |
| 1912191164 | Bonita Tao | Family Medicine | 7051 Alvarado Rd, La Mesa, CA 91942-8901 | 2007-08-30 |
| 1235187568 | Robert B Lajvardi | Family Medicine | 7051 Alvarado Rd, La Mesa, CA 91942 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
| 1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
| 1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
| 1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
| 1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
| 1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
| 1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
| 1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
| 1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
| 1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
| Find all providers in zip 91942 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972913622 | Yashveer Prasad Dubbula | Physician Assistant | 8851 Center Dr Ste 600, La Mesa, CA 91942-3061 | 2014-05-03 |
| 1336682236 | Hayley Ridenour | Physician Assistant | 7339 El Cajon Blvd Ste I, La Mesa, CA 91942-7435 | 2016-11-24 |
| 1477926319 | Amy Farabaugh | Physician Assistant | 7339 El Cajon Blvd, Suite I, La Mesa, CA 91942-7435 | 2015-10-31 |
| 1104254945 | Brittany Slaughter | Physician Assistant | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2013-10-14 |
| 1265723985 | Les Allen Mershon | Physician Assistant | 6136 Lake Murray Blvd, La Mesa, CA 91942-2502 | 2011-04-28 |
| 1447564141 | Cynthia Marie Adams | Physician Assistant | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2010-08-05 |
| 1770750978 | Kevin Matthew Delgadillo | Physician Assistant | 7862 El Cajon Blvd, La Mesa, CA 91942-6712 | 2008-05-15 |
| 1245359140 | Abraham Daneshvar | Physician Assistant | 8851 Center Dr, Suite 505, La Mesa, CA 91942-3017 | 2007-03-29 |
| 1164553459 | Brenda Lee Holmes | Physician Assistant | 8881 Fletcher Parkway, Suite # 370, La Mesa, CA 91942 | 2007-03-08 |
| 1871518100 | Aaron F Mendez | Physician Assistant | 5565 Grossmont Center Dr, Bldg 3 Suite 101, La Mesa, CA 91942-3020 | 2006-07-13 |
| Find all providers in LA 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.