KELLEY WAITE (NPI# 1376732560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376732560 |
| Entity Type | Individual |
| Full Name | KELLEY WAITE |
| Practice Address |
4555 Ogburn Ave Winston Salem NC 27105-2726 |
| Mailing Address |
200 E 2nd Ave Gastonia NC 28052-4358 |
| Practice Telephone | 3367137188 |
| Practice Fax Number | 3367137183 |
| Mailing Telephone | 7048741904 |
| Mailing Fax Number | 7048740707 |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5004403 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP 9238950 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 108 S State St, Yadkinville, NC 270558249 | 3366792733 | 3366796263 |
| Street Address |
4555 OGBURN AVE |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27105-2726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033176714 | Stephanie Wilson Davis | Nurse Practitioner | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2006-04-27 |
| 1730749870 | Sarah Baker | Nurse Practitioner | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2019-06-20 |
| 1730611815 | Katherine Rooney | Dietitian, Registered | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2017-03-29 |
| 1285042499 | Emily Rives | Marriage & Family Therapist | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2014-07-31 |
| 1225454689 | Tenesa Yashica Mccaskill-gainey | Registered Nurse | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2014-03-10 |
| 1760816953 | Leah Mckinney Baker | Physician Assistant | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2013-08-25 |
| 1831439637 | School Health Alliance for Forsyth County | Clinic/Center | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2013-02-15 |
| 1154453496 | Gaston Family Health Services, Inc. | Clinic/Center | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2007-03-12 |
| 1982732269 | School Health Alliance for Forsyth County | Clinic/Center | 4555 Ogburn Ave, Winston Salem, NC 27105-2726 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346711827 | Allison Colette Steinhaus | Counselor | 8025 Northpoint Blvd, Winston Salem, NC 27105 | 2018-12-10 |
| 1033600382 | Alterman & Dhillon Piedmont, Pplc | Dentist | 336 E Hanes Mill Rd, Winston Salem, NC 27105 | 2018-05-22 |
| 1336676030 | Goldsmith Quality Care LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 132 Jazer Ln, Winston Salem, NC 27105 | 2017-05-12 |
| 1427459981 | Tammy Bartlett | Physical Therapy Assistant | 4850 Sandusky St., Winston Salem, NC 27105 | 2014-09-15 |
| 1194154229 | Marla C Torrence | Counselor | 4140 N. Cherry Street, Winston Salem, NC 27105 | 2013-11-08 |
| 1629313051 | Lydia L. Barber | Counselor | 420 Forest Hills Ave, Winston Salem, NC 27105 | 2012-12-12 |
| 1023362530 | Helen Doby Martin | Home Health Aide | 4782 Butchwood Drive, Winston-salem, NC 27105 | 2012-11-06 |
| 1740545284 | Hines Good Samaritan Home | Technician | 2219 Manchester St., Winston-salem, NC 27105 | 2012-07-11 |
| 1043518129 | Alda Petra Bernardez | Pharmacist | 3539 Patterson Avenue, Winston Salem, NC 27105 | 2011-03-14 |
| 1225336449 | Alia Khaled Al-asfar | Pharmacist | 3539 Patterson Avenue., Winston Salem, NC 27105 | 2011-03-11 |
| Find all providers in zip 27105 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619576857 | Candace Allen | Nurse Practitioner | 1215 W Clemmonsville Rd, Winston Salem, NC 27127-4521 | 2020-10-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1427604883 | Jeanette Renea Torain | Nurse Practitioner | 145 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6983 | 2019-08-12 |
| 1841853876 | Sarah Monzella Pack | Nurse Practitioner | 3878 Oxford Station Way Ste A, Winston Salem, NC 27103-1340 | 2019-04-16 |
| 1720547425 | Ya Huster Taylor | Nurse Practitioner | 1005 Treble Ct, Winston Salem, NC 27127-5971 | 2019-03-13 |
| 1710450127 | Assumpta Kagaba | Nurse Practitioner | 3811 White Petals Ct, Winston Salem, NC 27107-6052 | 2019-01-08 |
| 1982189460 | Erica Segers | Nurse Practitioner | 4157 Kennison Village Dr, Winston Salem, NC 27127-6694 | 2018-10-01 |
| 1710433495 | Ikeshia Knight | Nurse Practitioner | 1831 Cahill Dr, Winston Salem, NC 27127-8828 | 2016-08-31 |
| 1487023495 | Porcial Washington Wilson | Nurse Practitioner | 755 Highland Oaks Dr Ste 202, Winston Salem, NC 27103-7106 | 2015-09-20 |
| 1316323124 | Elizabeth Arpe Goodman | Nurse Practitioner | 191 Wallburg High Point Rd, Winston Salem, NC 27107-9835 | 2015-08-04 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27105 |
Please comment or provide details below to improve the information on KELLEY WAITE.
| 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.