COURTNEY KELLY (NPI# 1235759077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235759077 |
| Entity Type | Individual |
| Full Name | COURTNEY KELLY |
| Credential | DMD |
| Practice Address |
1100 Wilford Hall Loop Bldg 4554 Jbsa Lackland TX 78236-5638 |
| Mailing Address |
1615 Truemper St San Antonio TX 78236-5511 |
| Practice Telephone | 6092303674 |
| Mailing Telephone | 6092303674 |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 11839022-9922 | UT | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3551 Roger Brooke Dr, Fort Sam Houston, TX 782344504 | 6092303674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073903266 | Courtney Kelly | Behavioral Analyst | 7 E Creek Cir, Guilford, CT 06437-2821 | 2015-01-27 |
| 1215541438 | Courtney Kelly | Social Worker | 311 Albert Sabin Way, Cincinnati, OH 45229-2838 | 2020-09-04 |
| 1134743768 | Courtney Kelly | Speech-Language Pathologist | 5835 Harbour View Blvd, Suffolk, VA 23435-2601 | 2020-05-29 |
| 1457988594 | Courtney Alexandra Kelly | Student in an Organized Health Care Education/Training Program | 8414 Naab Rd Ste 200, Indianapolis, IN 46260-1972 | 2020-03-26 |
| 1407330913 | Courtney Parker Kelly | Dentist | 100 57th St S, Birmingham, AL 35212-2541 | 2018-09-20 |
| 1720595549 | Courtney E Kelly | Nurse Practitioner | 1550 S Water St, Starke, FL 32091-4511 | 2018-01-02 |
| 1578966735 | Courtney Kelly | Nurse Anesthetist, Certified Registered | 4150 Nelson Rd Ste A4, Lake Charles, LA 70605-4169 | 2014-10-02 |
| 1295081933 | Courtney W Kelly | Pharmacist | 132 Alden Rd, Fairhaven, MA 02719-4721 | 2012-07-31 |
| 1831426725 | Courtney Lee Kelly | Nurse Practitioner | 8808 Balboa Ave, San Diego, CA 92123-1592 | 2009-11-12 |
| 1265628275 | Courtney Ann Kelly | Physician Assistant | 350 Surryse Rd, Suite 100, Lake Zurich, IL 60047-3217 | 2007-09-24 |
| Street Address |
1100 WILFORD HALL LOOP BLDG 4554 |
| City | JBSA LACKLAND |
| State | TX |
| Zip Code | 78236-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176266 | Peter S Scholler | Nurse Practitioner | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 | 2005-06-28 |
| 1376144428 | Steven Hilton | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-11-05 |
| 1326667783 | Shreena Reddy | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-04-15 |
| 1114556685 | Magin Day | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-04-06 |
| 1346879038 | Caitlin Gonsolin | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-04-03 |
| 1497383756 | Jerry Andrew Peer | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-03-31 |
| 1083241103 | Brian Patrick Staak | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-03-26 |
| 1902438583 | Andrew Kim | Physical Therapist | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-02-11 |
| 1326694845 | Ross Stanley | Dentist | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2019-08-12 |
| 1427614239 | Justin Staples | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2019-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1881972313 | Nicole Catarino | Dentist | 59 Dg-af Postgraduate Dental School, 2133 Pepperrell Street, Building 3352, Jbsa Lackland, TX 78236 | 2011-08-02 |
| 1518946995 | William Michael Anderson | Dentist | 2133 Pepperrell St, Jbsa Lackland, TX 78236-5313 | 2006-01-12 |
| 1801880588 | David L Mapes | Dentist | 1615 Truemper St, Jbsa Lackland, TX 78236-5511 | 2005-09-08 |
| 1902416027 | Austin Tyler | Dentist | 1615 Truemper St, Jbsa Lackland, TX 78236-5511 | 2020-08-04 |
| 1730708793 | Emily Sexton | Dentist | 1615 Truemper St Bldg 6418, Jbsa Lackland, TX 78236-5511 | 2020-04-10 |
| 1972145936 | Theresa Ten Haaf | Dentist | 1615 Truemper St, Jbsa Lackland, TX 78236-5511 | 2019-10-11 |
| 1679139877 | Benjamin Wang | Dentist | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236 | 2019-05-13 |
| 1750804845 | Marcela Land | Dentist | 1100 Wilford Hall Loop, Bldg 4554, Jbsa Lackland, TX 78236 | 2017-07-20 |
| 1912451170 | Tyler Paul Cody | Dentist | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236-9908 | 2016-08-05 |
| Find all providers in JBSA LACKLAND | ||||
| City | JBSA LACKLAND |
| Zip Code | 78236 |
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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.