KELLEY DICKSON (NPI# 1366071425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366071425 |
| Entity Type | Individual |
| Full Name | KELLEY DICKSON |
| Credential | DO |
| Practice Address |
1260 E Woodland Ave Ste 200 Springfield PA 19064-3988 |
| Mailing Address |
1424 Fairmount Ave Ph 211 Philadelphia PA 19130-2958 |
| Practice Telephone | 6106904471 |
| Mailing Telephone | 3015129141 |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1260 E WOODLAND AVE STE 200 |
| City | SPRINGFIELD |
| State | PA |
| Zip Code | 19064-3988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1316576275 | Joseph Panzera | Student in an Organized Health Care Education/Training Program | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2020-04-03 |
| 1134758204 | Eva Notis | Student in an Organized Health Care Education/Training Program | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2020-04-02 |
| 1649808783 | Meghan Mcdonald | Student in an Organized Health Care Education/Training Program | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2020-04-01 |
| 1760010847 | Gerald Scott Orlando II | Student in an Organized Health Care Education/Training Program | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2020-04-01 |
| 1619505799 | Wesley Stephan Hwang | Student in an Organized Health Care Education/Training Program | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2020-04-01 |
| 1730717653 | Samantha Arlene Diangelus | Student in an Organized Health Care Education/Training Program | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2020-03-27 |
| 1184284879 | Jennifer Tetzner | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2019-06-16 |
| 1386204196 | Mollie Baker-salisbury | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2019-06-14 |
| 1104485432 | Nicole Graham | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2019-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023513058 | Prospect Crozer Home Health and Hospice, LLC | Hospice Care, Community Based | 200 W. Sroul Road, Springfield, PA 19064 | 2018-03-30 |
| 1912369539 | Olga Burt | Physical Therapy Assistant | 146 Rose Lane, Springfield, PA 19064 | 2016-03-23 |
| 1124407309 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1745 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1477932655 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1755 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1003295288 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1765 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1427483742 | Casseys Optical Inc | Durable Medical Equipment & Medical Supplies | 139 S State Road, Springfield, PA 19064 | 2013-09-05 |
| 1184982225 | Ultimate Hearing Solutions II, LLC | Audiologist-Hearing Aid Fitter | 471 Baltimore Pike, Springfield, PA 19064 | 2012-04-26 |
| 1295091684 | Theresa Nolan | Registered Nurse | 194 West Sprould Road, Suite 105, Springfield, PA 19064 | 2012-04-10 |
| 1649551367 | Pa Center for Hearing and Balance, LLC | Hearing Aid Equipment | 760 W Sproul Road, Suite 103, Springfield, PA 19064 | 2011-09-08 |
| 1376864694 | Cynthia Lacapra | Family Medicine | 965 Baltimore Pike Ste B2, Springfield, PA 19064 | 2010-06-22 |
| Find all providers in zip 19064 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773361 | Aarika Danielle Gardner | Student in an Organized Health Care Education/Training Program | 560 W Bryant Apt D207, Springfield, MO 65810-8329 | 2020-08-31 |
| 1134743073 | Jared Saylor | Student in an Organized Health Care Education/Training Program | 901 S National Ave, Prof 160, Springfield, MO 65897 | 2020-06-06 |
| 1659995694 | Erin Bowler | Student in an Organized Health Care Education/Training Program | 51 Ingersoll Grv, Springfield, MA 01109-4010 | 2020-06-05 |
| 1063035483 | Mary Anne Iellamo | Student in an Organized Health Care Education/Training Program | 3400 Main St Fl 2, Springfield, MA 01199-1003 | 2020-05-20 |
| 1760005359 | Hannah Elizabeth Schumann | Student in an Organized Health Care Education/Training Program | 1621 E Lark St, Springfield, MO 65804-4351 | 2020-05-18 |
| 1962024109 | Brittany Nicole Campbell | Student in an Organized Health Care Education/Training Program | 2266 Boysenberry Ln Apt 4, Springfield, IL 62711-5414 | 2020-05-11 |
| 1518587286 | Emily Lyn Street | Student in an Organized Health Care Education/Training Program | 38 Country Pl, Springfield, IL 62703-5310 | 2020-04-22 |
| 1730709411 | Mary Kathleen Simon | Student in an Organized Health Care Education/Training Program | 1820 S Wiggins Ave, Springfield, IL 62704-3335 | 2020-04-22 |
| 1225658131 | Sarah Colby Mchugh | Student in an Organized Health Care Education/Training Program | 759 Chestnut St # S5427, Springfield, MA 01199-0001 | 2020-04-21 |
| 1346879889 | Ashly Seby | Student in an Organized Health Care Education/Training Program | 86 Redwood Rd Fl 3, Springfield, NJ 07081-2426 | 2020-04-06 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 19064 |
Please comment or provide details below to improve the information on KELLEY DICKSON.
| 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.