KELLY GONZALEZ (NPI# 1376028498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376028498 |
| Entity Type | Individual |
| Full Name | KELLY GONZALEZ |
| Practice Address |
440 Edmond Dr Dyer IN 46311-1523 |
| Practice Telephone | 1219322141 |
| Mailing Telephone | 1219322141 |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780147470 | Kelly Gonzalez | Licensed Vocational Nurse | 700 N White Oak Rd Lot B5, White Oak, TX 75693-2565 | 2019-04-09 |
| 1609324201 | Kelly Gonzalez | Nurse Practitioner | 11814 Tempest Harbor Loop, Venice, FL 34292-3821 | 2016-09-13 |
| 1285784611 | Kelly Lynn Gonzalez | Nurse's Aide | 1143 S Elm St, Washington Court House, OH 43160-2027 | 2007-01-10 |
| 1902900699 | Kelly H Gonzalez | Social Worker | 500 East Oglethorpe Highway, Hinesville, GA 31313 | 2006-09-12 |
| 1306384714 | Kelly Gonzalez | Behavior Technician | 800 Howe Ave Ste 140, Sacramento, CA 95825-3965 | 2017-02-06 |
| 1295127363 | Kelly Gonzalez | Registered Nurse | 21 Corporate Woods, 10870 Benson Drive #2160, Overland Park, KS 66210 | 2015-02-26 |
| 1952717027 | Kelly Gonzalez | Dentist | 12801 W Sunrise Blvd, F222, Sunrise, FL 33323-4020 | 2014-07-09 |
| Street Address |
440 EDMOND DR |
| City | DYER |
| State | IN |
| Zip Code | 46311-1523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750339362 | Virginia E Bratcher | Day Training/Habilitation Specialist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2006-05-05 |
| 1619511524 | Breanna Walton | Occupational Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2019-11-04 |
| 1124679048 | Brenda G Winkler | Occupational Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2019-09-23 |
| 1336799345 | Hannah R Opat | Speech-Language Pathologist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2019-09-12 |
| 1306305040 | Rebecca M Dill | Occupational Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2019-03-12 |
| 1023593134 | Staci Reyna | Developmental Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2018-09-25 |
| 1659856763 | Andrea Seeley | Developmental Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2018-09-25 |
| 1588158067 | Paige Creighton | Occupational Therapist | 440 Edmond Dr, Dyer, IN 46311-2315 | 2018-06-19 |
| 1073018354 | Raelene S Harvey | Occupational Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2018-03-28 |
| 1104331321 | Alexis Mary Mcmahon | Speech-Language Pathologist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2017-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407338858 | Leena Yousef-diaz | Nurse Practitioner | 1100 Joliet Street Suite #201, Dyer, IN 46311 | 2018-09-02 |
| 1518476639 | Kor Speech Therapy, LLC | Speech-Language Pathologist | 219 Primrose Dr., Dyer, IN 46311 | 2017-09-20 |
| 1861921207 | Derrick Durrah | Counselor | 2615 James Drive, Dyer, IN 46311 | 2017-06-08 |
| 1073962189 | Maria Lule | Pharmacist | 805 Joliet Road, Dyer, IN 46311 | 2016-06-09 |
| 1780072157 | Mario Munoz | Skilled Nursing Facility | 515 Audrey Ct, Dyer, IN 46311 | 2015-01-07 |
| 1457772451 | Lisa Jennifer Mickelson | Registered Nurse | 600 Joliet St., Kahler Middle School, Dyer, IN 46311 | 2013-12-18 |
| 1285055285 | Tanya D Burk-willson | Registered Nurse | 14600 W 81st St., Bibich Elementary, Dyer, IN 46311 | 2013-12-18 |
| 1013338011 | Mary Beth Rinaldi | Registered Nurse | 1121 Harrison Ave, Protsman Elementary, Dyer, IN 46311 | 2013-12-18 |
| 1023448057 | Franciscan Alliance | General Acute Care Hospital | 24 Joliet Street, 3da, Dyer, IN 46311 | 2013-11-12 |
| 1508078239 | Fatima Jaffer Md Sc PC | Internal Medicine | Physicians Pavilion Suite 101, 24 East Joliet Street, Dyer, IN 46311 | 2007-05-04 |
| Find all providers in zip 46311 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871611335 | Alicia B Tocci | Developmental Therapist | 1621 Briar Crossing Dr, Dyer, IN 46311-1656 | 2007-03-26 |
| 1023593134 | Staci Reyna | Developmental Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2018-09-25 |
| 1659856763 | Andrea Seeley | Developmental Therapist | 440 Edmond Dr, Dyer, IN 46311-1523 | 2018-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918757 | Alayna Kaye Gray | Developmental Therapist | 3825 S Woods Edge Bnd, Bloomington, IN 47401-8436 | 2020-09-25 |
| 1184236168 | Debbie Hargett | Developmental Therapist | 3911 Polk Rd, Boonville, IN 47601-8617 | 2020-08-20 |
| 1023620598 | Sarah C Dennis | Developmental Therapist | 1809 Columbus Blvd, Kokomo, IN 46901-1871 | 2020-08-17 |
| 1831709112 | Holly Ann Brinker | Developmental Therapist | 1302 Wallace Ave, Indianapolis, IN 46201-1844 | 2020-08-03 |
| 1245848746 | Bayley Brutus | Developmental Therapist | 3149 Congress Dr, Kokomo, IN 46902-8032 | 2020-07-21 |
| 1003431859 | Michele L Lloyd | Developmental Therapist | 975 S 650 E, Montgomery, IN 47558-5592 | 2020-06-08 |
| 1063032274 | Sharon Lynn Dalton | Developmental Therapist | 9957 S State Road 335, Pekin, IN 47165 | 2020-04-17 |
| 1457987612 | Sonya Overman | Developmental Therapist | 18241 County Road 40, Goshen, IN 46526-5447 | 2020-03-19 |
| 1144854449 | Karen M Moore | Developmental Therapist | 26191 Pocket Rd Apt 2, Batesville, IN 47006-9617 | 2020-02-25 |
| 1598397754 | Shannon Deann Belt | Developmental Therapist | 6084 N Daden Dr, Alexandria, IN 46001-9227 | 2020-02-06 |
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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.