DR. JOHN EDWARD KELLY JR. (NPI# 1386788628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386788628 |
| Entity Type | Individual |
| Full Name | DR. JOHN EDWARD KELLY JR. |
| Credential | M.D. |
| Practice Address |
5180 W Taft Rd N Syracuse NY 13212-2601 |
| Mailing Address |
Po Box 346 N Syracuse NY 13212-0346 |
| Practice Telephone | 3154584622 |
| Practice Fax Number | 3154589629 |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 082964 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902412893 | John Kelly | Home Health Aide | 337 Great Oaks Trl, Wadsworth, OH 44281-9427 | 2020-09-16 |
| 1952969826 | John Kelly | Community Health Worker | 4048 Crestwood Dr, Wausau, WI 54403-8122 | 2019-06-04 |
| 1629530712 | John J Kelly | Otolaryngology | 579 W Moorwood St, Green Valley, AZ 85614-5980 | 2019-04-05 |
| 1851886568 | John D Kelly | Counselor | 481 8th Ave Ste 520, New York, NY 10001-1809 | 2018-06-25 |
| 1255876041 | John Edward Kelly | Physician Assistant | 1340 Citizens Blvd, Leesburg, FL 34748-3924 | 2017-01-03 |
| 1225487986 | John Kelly | Pharmacist | 3761 Knollcroft St, Easton, PA 18045-3026 | 2016-06-03 |
| 1588023246 | John Kelly | Behavior Technician | 1118 Poindexter Ave W, Bremerton, WA 98312-4337 | 2016-02-23 |
| 1760880173 | John Kelly | Dentist | 4833 Bethesda Ave Ste 302, Bethesda, MD 20814-5244 | 2014-12-17 |
| 1508135252 | John Kelly | Counselor | 4550 Lantana Road, Suite A4, Lake Worth, FL 33463 | 2011-12-27 |
| 1497055008 | John Peter Kelly | Occupational Therapist | 21 Dorothy Ln, Kings Park, NY 11754-2932 | 2010-10-28 |
| Street Address |
5180 W TAFT RD |
| City | N SYRACUSE |
| State | NY |
| Zip Code | 13212-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891789707 | Kristen Ann Tyrrell | Nurse Practitioner | 5180 W Taft Rd, N Syracuse, NY 13212-2601 | 2005-09-07 |
| 1497072136 | Tina Lee Finlayson | Nurse Practitioner | 5180 W Taft Rd, N Syracuse, NY 13212-2601 | 2010-04-20 |
| 1821138165 | Patsy M Iannolo | Emergency Medicine | 5180 W Taft Rd, N Syracuse, NY 13212-2601 | 2007-02-07 |
| 1366582694 | Patsy M Iannolo Md, Phd, P C | Internal Medicine | 5180 W Taft Rd, N Syracuse, NY 13212-2601 | 2007-02-07 |
| 1497721757 | Sammy F. Suriani | Physician Assistant | 5180 W Taft Rd, N Syracuse, NY 13212-2601 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750845749 | Branches of Growth Mental Health Counseling, Pllc | Counselor | 3709 Brewerton Rd, Syracruse, NY 13212 | 2019-01-24 |
| 1821574070 | Nadia Marie James | Licensed Practical Nurse | 7175 Rose Wood Circle, North Syracuse, NY 13212 | 2018-07-11 |
| 1306364534 | Shonna Jolene Brodhead | Social Worker | Brightpath Counseling, 7266 Buckley Road, North Syracuse, NY 13212 | 2017-09-08 |
| 1477915189 | Karen Filapello | Speech-Language Pathologist | 320 Gateway Park Drive, @ Precision Contractors, N. Syracuse, NY 13212 | 2016-03-22 |
| 1285017095 | Lacey Foster | Skilled Nursing Facility | 5991 East Taft Rd, North Syracuse, NY 13212 | 2015-06-30 |
| 1346500345 | Wahienhawi Hall | Counselor | 7266 Buckley Rd., Bright Path Counseling Center, North Syracuse, NY 13212 | 2012-05-23 |
| 1316253768 | Jenny Barnum | Nurse Practitioner | 5232 Witz Dr, North Syracuse, NY 13212 | 2010-08-24 |
| 1063738797 | Gregory 'greg' Procopio | Registered Nurse | 308 Charlane Parkway, North Syracuse, NY 13212 | 2010-04-20 |
| 1316142243 | Carrie Marie Vincent | Specialist | 401north Main Street, North Syracuse, NY 13212 | 2007-06-20 |
| 1245307594 | Lynda Robin Kreitzer | Podiatrist | 316 South Main Street, North Syracuse, NY 13212 | 2006-11-30 |
| Find all providers in zip 13212 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144282278 | Yola Augustin | Internal Medicine | 511 S Main St, N Syracuse, NY 13212-2813 | 2006-04-04 |
| 1366582694 | Patsy M Iannolo Md, Phd, P C | Internal Medicine | 5180 W Taft Rd, N Syracuse, NY 13212-2601 | 2007-02-07 |
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| 1578177929 | Ar Personal Medical Care P.C. | Internal Medicine | 4102 75th Street, Elmhurst, NY 11373-3745 | 2020-09-03 |
| 1295348019 | Vault Medical Group Pa | Internal Medicine | 133 E 58th St Ste 512, New York, NY 10022-1145 | 2020-08-31 |
| 1770196602 | Julia A Mason | Internal Medicine | 78 Crescent Dr, Albany, NY 12208-1230 | 2020-08-29 |
| 1205447745 | Princeton Longevity Medical of New York Pllc | Internal Medicine | 1 World Trade Ctr Ste 71d, New York, NY 10007-0089 | 2020-08-10 |
| Find all providers with the same taxonomy | ||||
| City | N SYRACUSE |
| Zip Code | 13212 |
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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.