JANA S KELLAM (NPI# 1356495683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356495683 |
| Entity Type | Individual |
| Full Name | JANA S KELLAM |
| Credential | CPNP |
| Practice Address |
11 Berkshire Rd Smithfield NC 27577 |
| Mailing Address |
11 Berkshire Rd Smithfield NC 27577-4748 |
| Practice Telephone | 9199340564 |
| Practice Fax Number | 9199349703 |
| Mailing Telephone | 9199340564 |
| Mailing Fax Number | 9199349703 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2019-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
300242 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7005951 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 Kellie Dr, Smithfield, NC 275779443 | 9199383749 | 9199383795 |
| Street Address |
11 BERKSHIRE RD |
| City | SMITHFIELD |
| State | NC |
| Zip Code | 27577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831159391 | Sally Lawson Carpenter | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2006-03-27 |
| 1770826950 | Shannon Ford | Nurse Practitioner | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2013-04-05 |
| 1609066273 | Johnston County Pediatrics | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577 | 2007-07-30 |
| 1255499752 | Johnston County Pediatrics | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919047 | Sherwin Cuaresma Bernardino | Physical Therapist | Meadowview Assisted Living Center, 250 Nc-210, Smithfield, NC 27577 | 2020-07-14 |
| 1386297299 | Johnston Opco, LLC | Non-emergency Medical Transport (VAN) | 200 Kellie Dr, Smithfield, NC 27577 | 2019-07-19 |
| 1790255362 | Adrian Brook Taylor | Physical Therapist | 540 North Street, Smithfield, NC 27577 | 2018-11-27 |
| 1497260608 | Providence Healthcare of The Carolinas | Assisted Living Facility | 4302 Hwy Nc 210, Smithfield, NC 27577 | 2017-12-11 |
| 1720593908 | Latorya Delois Moore | Nurse Practitioner | 514 N Brightleaf Blvd Ste 1100, Smithfield, NC 27577 | 2017-12-09 |
| 1124546171 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 104 N Brightleaf Blvd, Smithfield, NC 27577 | 2017-08-30 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1407203318 | Linda Pearl Trujillo | Early Intervention Provider Agency | 623 Tralee Dr, Smithfield, NC 27577 | 2016-05-20 |
| 1336500206 | Saundra Casey | Counselor | 15 Noble Street, Smithfield, NC 27577 | 2016-03-18 |
| 1639537707 | Ralph Edwin Wilson Jr. | Physician Assistant | 100 Kellie Drive, Smithfield, NC 27577 | 2016-02-04 |
| Find all providers in zip 27577 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962442376 | Sharon Q Capuano | Nurse Practitioner | 1150 Douglas Pike, Smithfield, RI 02917 | 2006-06-07 |
| 1609488535 | Alexis Fernandez | Nurse Practitioner | 1519 E Booker Dairy Rd, Smithfield, NC 27577-9472 | 2020-08-21 |
| 1467954396 | Caroline Bernthal | Nurse Practitioner | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2018-03-07 |
| 1245698620 | Ashleigh Pappadake Martin | Nurse Practitioner | 1519 E Booker Dairy Rd, Smithfield, NC 27577-9472 | 2016-02-01 |
| 1467817353 | Jacqueline Grooms Oliver | Nurse Practitioner | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2015-12-21 |
| 1770826950 | Shannon Ford | Nurse Practitioner | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2013-04-05 |
| 1013065390 | Karen H Merritt | Nurse Practitioner | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594732 | Megan Hoekstra | Nurse Practitioner | 8358 Six Forks Rd Ste 204, Raleigh, NC 27615-5093 | 2020-10-04 |
| 1639713118 | Holly Hattler Barber | Nurse Practitioner | Unc Dept of Pediatrics 030 Macnider Hall Cb 7231, Chapel Hill, NC 27599-0001 | 2019-10-29 |
| 1437709565 | Molly Benson Miller | Nurse Practitioner | 101 Manning Dr Cb 7236, Chapel Hill, NC 27599-7236 | 2019-09-20 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1548814072 | Ashley Goodwin Friddle | Nurse Practitioner | 802 Green Valley Rd Ste 210, Greensboro, NC 27408-7099 | 2019-08-01 |
| 1740743129 | Jennifer W Farrow | Nurse Practitioner | 940 Se Cary Pkwy Ste 200, Cary, NC 27518-7417 | 2019-04-11 |
| 1538641147 | Taylor Rippy | Nurse Practitioner | 2304 Delaney Ave, Wilmington, NC 28403-6013 | 2018-08-30 |
| 1427544931 | Sheila L Mason | Nurse Practitioner | Wfbmc 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2018-07-09 |
| 1770099319 | Jillian Hernandez Sprague | Nurse Practitioner | 101 E Matthews St Ste 800, Matthews, NC 28105-5374 | 2017-12-19 |
| 1427587625 | Amanda Register | Nurse Practitioner | 110 E Park Dr, Beulaville, NC 28518-6916 | 2017-06-09 |
| Find all providers with the same taxonomy | ||||
| City | SMITHFIELD |
| Zip Code | 27577 |
Please comment or provide details below to improve the information on JANA S KELLAM.
| 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.