MR. DAN DALE KELLY (NPI# 1285952101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285952101 |
| Entity Type | Individual |
| Full Name | MR. DAN DALE KELLY |
| Practice Address |
120 Birch St Shady Cove OR 97539 |
| Mailing Address |
Po Box 1516 Shady Cove OR 97539 |
| Practice Telephone | 5418782429 |
| Mailing Telephone | 5418782429 |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-05-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172A00000X | Driver | Other Service Providers | ||
| N | 372500000X | Chore Provider | Nursing Service Related Providers | ||
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740639509 | Dan Albert Kelly | Pediatrics | 4604 Sw Crenshaw Dr, Topeka, KS 66610-1656 | 2016-06-11 |
| Street Address |
120 BIRCH ST |
| City | SHADY COVE |
| State | OR |
| Zip Code | 97539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902421811 | John Paul Hurd | Chiropractor | 21885 Or62, Shady Cove, OR 97539 | 2020-06-16 |
| 1811488851 | Shady Cove Chiropractic and Massage, LLC | Chiropractor | 21885 Or-62, Shady Cove, OR 97539 | 2018-05-25 |
| 1427444264 | Philip Broesamle | Counselor | 60 Mallory Ln., Shady Cove, OR 97539 | 2015-04-08 |
| 1285060772 | Neil Dale Arnspiger | Behavioral Analyst | 159 Train Lane, Shady Cove, OR 97539 | 2013-09-17 |
| 1104089309 | Kelly Clayton Fnp Inc | Clinic/Center | 387 Pinetop Terrace, Shady Cove, OR 97539 | 2008-07-08 |
| 1285786525 | Robert Russell Bennett | Chiropractor | 21885 Highway 62, Shady Cove, OR 97539 | 2007-01-17 |
| 1881770808 | Sisters of Providence In Oregon | Clinic/Center | 25 Erickson Avenue, Shady Cove, OR 97539 | 2006-10-31 |
| 1053424622 | Phillip Bruce Lassen | Dentist | 21978 Hwy 62, Shady Cove, OR 97539-1236 | 2006-08-16 |
| 1922249382 | David Lee Thompson | Physical Therapy Assistant | 20 Laurel Dr, Shady Cove, OR 97539-3602 | 2009-03-16 |
| 1750861431 | Casey Dean Clingan | Dentist | 21300 Highway 62, Shady Cove, OR 97539-7707 | 2018-08-21 |
| Find all providers in zip 97539 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417590035 | Holly Marie Smith | Adult Companion | 4849 Sedona Dr, Eugene, OR 97404-3309 | 2019-10-27 |
| 1184271462 | Taylor Salter | Adult Companion | 7018 N Armour St, Portland, OR 97203-6132 | 2019-08-21 |
| 1235785429 | Lonzall Tatum | Adult Companion | 1212 Sw Clay St Apt 409, Portland, OR 97201-7822 | 2019-08-13 |
| 1336700848 | Blake Gibson Whitaker | Adult Companion | 2005 Sw Leewood Dr, Aloha, OR 97003-2104 | 2019-06-25 |
| 1205303021 | Imani Anderson | Adult Companion | 434 Ne Roselawn St, Portland, OR 97211-3826 | 2018-10-30 |
| 1275013195 | Brandon Stephen Lime | Adult Companion | 3516 Nw Coronado St, Corvallis, OR 97330-4695 | 2018-08-20 |
| 1598256224 | Krystle Anderson | Adult Companion | 4289 Sw Battaglia Pl, Gresham, OR 97080-8645 | 2018-05-29 |
| 1780184879 | Zoe Rose Littlebury Oftedal | Adult Companion | 1500 Valley River Dr, Eugene, OR 97401-2130 | 2018-02-15 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1104364900 | Rosanna Hunnicutt | Adult Companion | 2601 Se 160th Ave, Portland, OR 97236-2092 | 2017-02-01 |
| Find all providers with the same taxonomy | ||||
| City | SHADY COVE |
| Zip Code | 97539 |
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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.