KATHLEEN KELLEY (NPI# 1245626225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245626225 |
| Entity Type | Individual |
| Full Name | KATHLEEN KELLEY |
| Credential | M.D. |
| Practice Address |
1815 E Ireland Rd South Bend IN 46614 |
| Mailing Address |
1815 E Ireland Rd South Bend IN 46614-2845 |
| Practice Telephone | 5746471700 |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2019-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 01082520A | IN | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 12506743 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972910925 | Kathleen Kelley | Social Worker | 2813e Wyoming Dr, Sinking Spring, PA 19608-1618 | 2014-07-22 |
| 1568691756 | Kathleen Kelley | Nurse Practitioner | 15110 Boones Ferry Rd Ste 248, Lake Oswego, OR 97035-3498 | 2009-07-08 |
| 1477617447 | Kathleen Kelley | Counselor | 99 University Place, 4th Floor, New York, NY 10003-8971 | 2006-12-21 |
| 1649388513 | Kathleen M Kelley | Nurse Practitioner | 1952 Long Grove Dr, Suite 202, Mt Pleasant, SC 29464 | 2006-08-29 |
| 1265443014 | Kathleen Cranford Kelley | Nurse Practitioner | 1092 General George Patton Rd, Nashville, TN 37221-2599 | 2006-08-10 |
| 1871501353 | Kathleen Ann Kelley | Pharmacist | 2943 Seneca Street, West Seneca, NY 14224-1950 | 2006-08-03 |
| 1992760797 | Kathleen S. Kelley | Internal Medicine | 498 University Blvd, Suite F, Harrisonburg, VA 22801 | 2006-04-18 |
| 1952773525 | Kathleen Kelley | Physician Assistant | 464 Congress Ave, Suite 260, New Haven, CT 06519-1361 | 2015-10-22 |
| 1861882557 | Kathleen Helen Kelley | Dietitian, Registered | 15 Palomba Dr, 2, Enfield, CT 06082-3888 | 2015-02-02 |
| 1285961839 | Kathleen Kelley | Physical Therapist | 800 Kensington Ave Ste 100, Missoula, MT 59801-5670 | 2009-11-03 |
| Street Address |
1815 E IRELAND RD |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396733101 | Douglas Mayer David | Family Medicine | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2005-10-06 |
| 1699322446 | Evelin Keultjes | Nurse Practitioner | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2019-08-26 |
| 1548766249 | Dena Nichole Garnett | Physical Therapist | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2018-04-02 |
| 1467909697 | Sarah Anne Martin | Physician Assistant | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2016-09-06 |
| 1245685510 | Kristin Jamison | Nurse Practitioner | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2016-04-25 |
| 1881085967 | Shanti T Dalson | Physical Therapist | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2015-02-11 |
| 1144660838 | Amanda Leanne Springer | Family Medicine | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2013-06-27 |
| 1225321722 | Luiz C Pantalena Filho | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2011-05-17 |
| 1437388220 | Jill M. Maddox | Nurse Practitioner | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2009-07-14 |
| 1518123124 | Daniel Matthew Kinney | Pediatrics | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2008-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417574013 | Hellen Gathesha | Nurse Practitioner | 2123 W Irvington Dr, South Bend, IN 46614 | 2020-06-30 |
| 1033759394 | Diane Galvas | Pharmacist | 1217 E. Ireland Rd., South Bend, IN 46614 | 2020-01-14 |
| 1730668690 | Julenne Henriquez-gil | Physical Therapist | 202 W Ireland Rd Ste 101a, South Bend, IN 46614 | 2018-08-11 |
| 1467747014 | Deidre A Coffey | Nurse Practitioner | 1025 Widener Ln, South Bend, IN 46614 | 2011-06-12 |
| 1588727655 | Wal-mart Stores East, Lp | Technician/Technologist | 700 W. Ireland Rd., South Bend, IN 46614 | 2006-12-19 |
| 1437262847 | Lori F Risser | Dentist | 734 E Ireland Rd, South Bend, IN 46614 | 2006-08-17 |
| 1912388018 | Laura Ellen Albright | Family Medicine | 2102 E Inwood Rd, South Bend, IN 46614 | 2015-06-15 |
| 1073869806 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1950 Ridgedale Rd, South Bend, IN 46614 | 2012-07-30 |
| 1326300666 | Kristine Marie Jones | Optometrist | 700 W Ireland Rd, South Bend, IN 46614 | 2012-06-12 |
| 1760766968 | John Thomas Miller | Pharmacist | 1010 E Ireland Rd, South Bend, IN 46614 | 2011-10-06 |
| Find all providers in zip 46614 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225321722 | Luiz C Pantalena Filho | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2011-05-17 |
| 1821222829 | Beacon Medical Group, Inc. | Dermatology | 615 N Michigan St, First Floor Hospitalist Suite, South Bend, IN 46601 | 2009-05-06 |
| 1134189053 | Linda Higginbotham | Dermatology | 211 N Eddy St, South Bend, IN 46617-2808 | 2006-03-24 |
| 1861482234 | Mary K Harder | Dermatology | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-26 |
| 1649260233 | Cynthia E Mayfield | Dermatology | 2102 E Inwood Rd, South Bend, IN 46614-2443 | 2005-10-25 |
| 1538159207 | Holly L Hake-harris | Dermatology | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457998692 | Medovate, LLC | Dermatology | 9305 Calumet Ave Ste A1, Munster, IN 46321-2888 | 2019-12-06 |
| 1386107829 | Strausburg Dermatology Group LLC | Dermatology | 92 S Park Blvd, Greenwood, IN 46143-8836 | 2019-04-11 |
| 1467834127 | Emily W Shelley | Dermatology | 8433 Harcourt Rd Ste 310, Indianapolis, IN 46260-2198 | 2015-06-18 |
| 1396133518 | Forefront Dermatology, S.c. | Dermatology | 188 State Road 129 S. Ste B, Batesville Medical Arts Bldg, Batesville, IN 47006 | 2014-12-23 |
| 1003211392 | Forefront Dermatology, S.c. | Dermatology | 1473 N Gardner St Ste A, C/o Scott Memorial Hospital, Scottsburg, IN 47170 | 2014-10-29 |
| 1639580152 | Nikolajs Perdue | Dermatology | 6820 Parkdale Pl Ste 211, Indianapolis, IN 46254-6600 | 2014-05-19 |
| 1356785778 | Larry Gene Bond | Dermatology | 9637 W. County Rd 200 N., Frankfort, IN 46041 | 2013-04-29 |
| 1093057911 | Matthew Bradley Strausburg | Dermatology | 9292 N Meridian St Ste 210, Indianapolis, IN 46260-1828 | 2013-03-18 |
| 1730430513 | Robert Marshall Weiss | Dermatology | 6017 Benchmark-one, Floyds Knobs, IN 47119-9410 | 2012-09-20 |
| 1346597655 | Franciscan Medical Specialists | Dermatology | 757-45th Street, Ste 201, Munster, IN 46321 | 2012-08-07 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46614 |
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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.