MS. KATHERINE A KELLEY


Address: 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292
Phone: 6162677100

MS. KATHERINE A KELLEY (NPI# 1245598820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245598820
Entity Type Individual
Full Name MS. KATHERINE A KELLEY
Credential M.D.
Practice Address 4100 Lake Dr Se Ste 205
Grand Rapids
MI 49546-8292
Practice Telephone 6162677100
Mailing Telephone 6162677100
Enumeration Date 2012-05-02
Last Update Date 2020-10-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208C00000X Colon & Rectal Surgery 4301500354 MI Allopathic & Osteopathic Physicians

Other Providers KATHERINE KELLEY

NPI Name Taxonomy Address Enumeration
1336704592 Katherine Kelley Student in an Organized Health Care Education/Training Program 3901 Chrysler Dr Ste 5a, Detroit, MI 48201-2167 2019-05-03
1396230405 Katherine Kelley Occupational Therapy Assistant 150 Elden St Ste 270, Herndon, VA 20170-4845 2018-06-30
1831408129 Katherine Alma Kelley Counselor 269 Pearl St Ste 2, Burlington, VT 05401-8536 2010-10-04
1548874225 Katherine Kelley Behavior Technician 8500 Washington St Ne Ste A1, Albuquerque, NM 87113-1861 2020-09-01
1801427992 Katherine Mary Kelley Technician, Health Information 3438 S 148th St, Tukwila, WA 98168-4319 2020-01-28
1760031694 Katherine Emily Kelley Clinical Neuropsychologist 100 N. Academy Ave, Department of Psychiatry, Geisinger Medical Center, Danville, PA 17822 2019-09-04
1619436052 Katherine Frances Kelley Behavior Technician 1675 Sw Marlow Ave Ste 200, Portland, OR 97225-5102 2019-03-15
1316398845 Katherine Helene Kelley Social Worker 10 Gove St, East Boston, MA 02128-1920 2016-06-27
1770981086 Katherine T Kelley Nurse Anesthetist, Certified Registered 1500 E Shotwell St, Bainbridge, GA 39819-4256 2014-12-18
1770926131 Katherine Marie Kelley Surgery 22 S Greene St, Baltimore, MD 21201 2013-04-16

Office Location

Street Address 4100 LAKE DR SE STE 205
City GRAND RAPIDS
State MI
Zip Code 49546-8292

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699001156 Thomas Jay Beverwyk Physician Assistant 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2009-10-19
1265073027 Jared Thomas Courtright Physician Assistant 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2019-10-03
1225596588 Sheila Marie Zank Nurse Practitioner 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2019-03-06
1417421405 Margaret Elizabeth Peklo Nurse Practitioner 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2019-01-14
1588031256 Sarah Catherine Roy Nurse Practitioner 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2015-08-28
1861890683 Sandra Lynn Allen Physician Assistant 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2014-12-10
1871995399 Brittany Mara Dean Physician Assistant 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2014-09-17
1104247410 Ross Reynolds Physician Assistant 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2014-01-05
1760724132 Matthew James Nelson Internal Medicine 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2013-03-22
1821379132 David Mark Ophoff Physician Assistant 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 2011-08-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437762986 Amanda Mae Ostrom Speech-Language Pathologist 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 2020-08-25
1063075562 Kelly Lynn Ibarra Counselor 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 2019-04-19
1891257036 Jessica Matthews LLC Counselor 4127 Embassy Drive Se, Grand Rapids, MI 49546 2019-04-05
1326518531 Neah Morgan Technician 4220 Burton St Se, Grand Rapids, MI 49546 2018-11-29
1316430267 Michael John Benskey Case Manager/Care Coordinator 4065 Saladin St Se, Grand Rapids, MI 49546 2018-06-14
1679062772 Smile Cascade, P.C. Clinic/Center 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 2018-05-03
1720583289 Jeromy Krogman Counselor 826 Parchment Drive Se, Grand Rapids, MI 49546 2018-03-27
1841792660 Affordable Hearing Clinic Hearing Instrument Specialist 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 2018-03-07
1689176133 Kelly Pines Physical Therapist 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 2018-03-01
1467971440 Deanna Elizabeth Saenz Social Worker 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 2017-09-12
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Taxonomy Information

Taxonomy Code 208C00000X
Grouping Allopathic & Osteopathic Physicians
Classification Colon & Rectal Surgery

Taxonomy Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1841716073 Adnan Qureshi Colon & Rectal Surgery 1840 Wealthy St Se, Grand Rapids, MI 49506-2921 2017-08-18
1730613027 Rohin Mittal Colon & Rectal Surgery 945 Ottawa Ave Nw, Grand Rapids, MI 49503-1431 2017-04-13
1952604878 Spectrum Health Primary Care Partners Colon & Rectal Surgery 1179 E Paris Ave Se, Ste. 200, Grand Rapids, MI 49546-8371 2010-12-15
1194037127 Spectrum Health Primary Care Partners Colon & Rectal Surgery 3230 Eagle Park Dr Ne, Suite 210, Grand Rapids, MI 49525-7007 2010-07-07
1356653380 Spectrum Health Primary Care Partners Colon & Rectal Surgery 4069 Lake Dr Se, Grand Rapids, MI 49546-8816 2010-07-07
1861515504 Michael Colin Ott Colon & Rectal Surgery 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 2007-04-09
1124069703 Martin Luchtefeld Colon & Rectal Surgery 4100 Lake Dr Se, S-205, Grand Rapids, MI 49546-8292 2006-06-08
1568419745 Rebecca Hoedema Colon & Rectal Surgery 4100 Lake Dr Se, S-205, Grand Rapids, MI 49546-8292 2006-05-31
1154378404 Heather Slay Colon & Rectal Surgery 4100 Lake Dr Se, S-205, Grand Rapids, MI 49546-8292 2006-05-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1649566068 Kristin M Busch Colon & Rectal Surgery 4201 Campus Ridge Dr, Midland, MI 48640-6128 2011-06-23
1215245329 Warren P Mazier Colon & Rectal Surgery 7701 Conservation St Ne, Ada, MI 49301-9522 2010-09-23
1346566908 William Lionel Beauregard Colon & Rectal Surgery 4406 Birch Run Dr, Troy, MI 48098-4341 2010-04-07
1114140167 Ralph D Pearlman Md PC Colon & Rectal Surgery 22250 Providence Dr Ste 702, Southfield, MI 48075-6215 2007-04-10
1770637753 Chairat Chomchai Colon & Rectal Surgery 28111 Hoover Road, Suite 6a, Warren, MI 48093 2007-01-23
1225191844 John C. Eggenberger Colon & Rectal Surgery 5325 Elliott Dr Ste 104, Ypsilanti, MI 48197-8633 2006-12-18
1518051358 Colon and Rectal Surgery Associates PC Colon & Rectal Surgery 1126 Gull Rd, Kalamazoo, MI 49048 2006-10-03
1568569655 Farouk S Tootla Colon & Rectal Surgery 44060 Woodward Ave, Bloomfield Hills, MI 48302-5038 2006-09-20
1962470435 Harold D Friedl Colon & Rectal Surgery 1126 Gull Road, Colon and Rectal Surgery Associates PC, Kalamazoo, MI 49048-1726 2006-03-10
1619950631 Ganesh R Deshmukh Colon & Rectal Surgery 3106 S Wayne Rd, Wayne, MI 48184 2005-11-23
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Competitor

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City GRAND RAPIDS
Zip Code 49546

Improve Information

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Dataset Information

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.

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