MRS. KELLY R RICHARDSON (NPI# 1225038086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225038086 |
| Entity Type | Individual |
| Full Name | MRS. KELLY R RICHARDSON |
| Credential | PA-C |
| Practice Address |
914 N Dixie Ave Suite 304 Elizabethtown KY 42701-2520 |
| Practice Telephone | 2707691049 |
| Practice Fax Number | 2707351978 |
| Mailing Telephone | 2707691049 |
| Mailing Fax Number | 2707351978 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2015-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA816 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 95004131 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295162386 | Kelly C Richardson | Speech-Language Pathologist | 3435 Main Street, 52 Biomedical Education Building, Ub Speech-language and Hearing Clinic, Buffalo, NY 14214-8016 | 2013-10-03 |
| 1306167879 | Kelly Golliher Richardson | Nurse Practitioner | 314 Calumet Pl, San Antonio, TX 78209-3402 | 2010-06-18 |
| 1760618730 | Kelly Lynae Richardson | Physician Assistant | 5121 S Cottonwood St Ste 320, Murray, UT 84107-5701 | 2009-06-04 |
| 1255946851 | Kelly Richardson | Behavior Technician | 4 Rossi Cir, Suite 141, Salinas, CA 93907-2362 | 2020-09-10 |
| 1811408214 | Kelly Richardson | Nurse Practitioner | 2520 5th St N, Columbus, MS 39705-2008 | 2017-10-12 |
| 1952846032 | Kelly Richardson | Counselor | 14255 Sw Brigadoon Ct, Beaverton, OR 97005-3369 | 2016-12-29 |
| 1730639857 | Kelly Richardson | Physical Therapist | 2197 Madison St, Suite 106, Clarksville, TN 37043-5284 | 2016-10-13 |
| 1235527946 | Kelly Richardson | Marriage & Family Therapist | 215 W Beamer St, Woodland, CA 95695-2510 | 2015-01-03 |
| 1558769661 | Kelly Nicole Richardson | Counselor | 6707 Whitestone Rd, Gwynn Oak, MD 21207-4106 | 2014-12-05 |
| 1750707873 | Kelly Richardson | Counselor | 602 Sw 38th St, Lawton, OK 73505-6912 | 2014-03-13 |
| Street Address |
914 N DIXIE AVE SUITE 304 |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-2520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295010833 | Etown Infusion Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 914 N Dixie Ave, Suite 101, Elizabethtown, KY 42701-2520 | 2011-10-14 |
| 1184894461 | Sleep Management, LLC | Durable Medical Equipment & Medical Supplies | 914 N Dixie Ave, Ste 106, Elizabethtown, KY 42701-2520 | 2008-03-03 |
| 1043423429 | Heartland Patient Care, Pllc | Internal Medicine | 914 N Dixie Ave, Suite 302, Elizabethtown, KY 42701-2520 | 2007-05-08 |
| 1215149273 | Heartland Internal Medicine Pllc. | Internal Medicine | 914 N Dixie Ave, Elizabethtown, KY 42701-2520 | 2007-05-04 |
| 1912037383 | Ordie L Day II | Dentist | 914 N Dixie Ave, Suite 207, Elizabethtown, KY 42701-2520 | 2007-03-06 |
| 1932266947 | A.m. Faheem, M.d., P.s.c. | Specialist | 914 N Dixie Ave, Suite 302, Elizabethtown, KY 42701-2520 | 2007-01-02 |
| 1467520098 | Javier J Arce Md Psc | Spec/Tech, Cardiovascular | 914 N Dixie Ave, Suite 203, Elizabethtown, KY 42701-2520 | 2006-12-01 |
| 1235217928 | Dr. Elizabeth D. Sebree Md Psc | Obstetrics & Gynecology | 914 N Dixie Ave, Suite 208, Elizabethtown, KY 42701-2520 | 2006-11-01 |
| 1144327339 | Henry H. Bunch | Dentist | 914 N Dixie Ave, Suite 200, Elizabethtown, KY 42701-2520 | 2006-09-20 |
| 1811004542 | Amjad Mohammed Faheem | Internal Medicine | 914 N Dixie Ave, Suite 302, Elizabethtown, KY 42701-2520 | 2006-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| 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 |
|---|---|---|---|---|
| 1821514944 | Thomas Caleb Watts | Physician Assistant | 1310 Woodland Dr, Elizabethtown, KY 42701-2651 | 2017-08-21 |
| 1992037709 | Pack Family Medicine, Pllc | Physician Assistant | 212 S Pine St, Elizabethtown, NC 28337-9163 | 2010-02-03 |
| 1992940233 | Jamie Lynn Hammond | Physician Assistant | 300a Mckay St, Elizabethtown, NC 28337-9037 | 2008-12-15 |
| 1518111509 | Todd Michael Rowe | Physician Assistant | 1414 Amandajo Dr, Elizabethtown, KY 42701-4639 | 2008-11-04 |
| 1427152438 | Lyn A Govette | Physician Assistant | 426 East G St, Elizabethtown, TN 37643 | 2006-09-11 |
| 1154303675 | Brandon Chase Wampler | Physician Assistant | 2412 Ring Rd Ste 200, Elizabethtown, KY 42701-5913 | 2005-11-18 |
| 1447250584 | Chanty Lynn Headspeth | Physician Assistant | 906 Woodland Dr, Ste 102, Elizabethtown, KY 42701-2752 | 2005-07-29 |
| 1124028246 | Carla Renee Fray | Physician Assistant | 101 Financial Pl Ste 104, Elizabethtown, KY 42701-8481 | 2005-07-29 |
| 1548872583 | Zachary David Martin | Physician Assistant | 1 Continental Dr, Elizabethtown, PA 17022-2231 | 2020-08-20 |
| 1548878010 | Alexander David Miller | Physician Assistant | 418 Cloverleaf Rd, Elizabethtown, PA 17022-9320 | 2020-07-21 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on MRS. KELLY R RICHARDSON.
| 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.