TARA M KELLY (NPI# 1396995163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396995163 |
| Entity Type | Individual |
| Full Name | TARA M KELLY |
| Credential | CRNP |
| Practice Address |
200 W Arbor Dr San Diego CA 92103-9000 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 8586577000 |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2018-01-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
95001320 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144623844 | Tara Marie Kelly | Speech-Language Pathologist | 520 Ne Ravenna Blvd, Seattle, WA 98115-6460 | 2014-10-08 |
| 1073809992 | Tara Kelly | Counselor | 309 S 7th St Ste A, Adel, IA 50003-1838 | 2011-06-20 |
| 1902411655 | Tara Kelly | Counselor | 548 S 17th St, Harrisburg, PA 17104-2223 | 2020-09-10 |
| 1487272449 | Tara Kelly | Social Worker | 591 Lakehurst Rd, Toms River, NJ 08755-8045 | 2020-07-07 |
| 1790135903 | Tara Lynn Kelly | Anesthesiology | 169 Ashley Ave, Room 202 Main Hospital Msc333, Charleston, SC 29425-8905 | 2016-06-18 |
| 1770909855 | Tara K. Kelly | Specialist/Technologist | 1605 W Main St, Norristown, PA 19403-3229 | 2014-03-12 |
| 1346505930 | Tara Lynn Kelly | Student in an Organized Health Care Education/Training Program | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2012-07-10 |
| 1326300070 | Tara Kelly | Specialist | 300 Garden City Plaza, Garden City, NY 11530 | 2012-06-08 |
| 1558650416 | Tara Leigh Kelly | Student in an Organized Health Care Education/Training Program | 350 E 17th St, 20th Floor, Baird Hall, New York, NY 10003-3805 | 2011-03-31 |
| 1376689547 | Tara Kelly | Nurse Practitioner | 3220 S Douglas Rd Ste B, Miramar, FL 33025-2734 | 2007-01-29 |
| Street Address |
200 W ARBOR DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215502 | Alfredo B. Tiu | Internal Medicine | 200 W Arbor Dr, Owen Clinic, San Diego, CA 92103-9001 | 2005-06-20 |
| 1841806536 | Kevin Thai Nguyen | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-18 |
| 1003421256 | Jessica Lynette Montoya | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-14 |
| 1013522838 | Julianna L Gorder | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-09 |
| 1992318828 | Yodit Mekonnen Teklu | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1356954283 | Dalia Siada | Dietitian, Registered | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1699383588 | Rachael Ashley Gordon | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-17 |
| 1124646906 | Jeffrey David Bernstein | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr, Mc 1234, San Diego, CA 92103-9000 | 2020-07-08 |
| 1639796071 | Darcie D Brown | Marriage & Family Therapist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-01 |
| 1194340919 | Han B Dinh | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714007 | Julissa Leonides Caraballo | Nurse Practitioner | 4044 Promontory St, San Diego, CA 92109-5334 | 2020-03-07 |
| 1427543685 | Meredith Cronenwett | Nurse Practitioner | 8793 Lightwave Ave, San Diego, CA 92123-5000 | 2018-06-28 |
| 1891288056 | Ayodele Bolatito Akinsuyi | Nurse Practitioner | 11287 Featherhill Ln, San Diego, CA 92126-4873 | 2018-06-12 |
| 1366958092 | Sylvia Akua Searleman | Nurse Practitioner | 17927 Aguamiel Rd, San Diego, CA 92127-1039 | 2017-12-18 |
| 1346752219 | Gurpreet Sahota | Nurse Practitioner | 7270 Rondel Ct, San Diego, CA 92119-1526 | 2017-10-31 |
| 1861912495 | Tejinder Kaur Dhandi | Nurse Practitioner | 12204 Briar Knoll Way, San Diego, CA 92128-6307 | 2017-06-24 |
| 1245782689 | Ellen Ward | Nurse Practitioner | 4320 Genesee Ave Ste 104, San Diego, CA 92117-4900 | 2016-11-02 |
| 1285088369 | Jackie Irene Nembo Kom | Nurse Practitioner | 17809 Kachina Ct, San Diego, CA 92127-1368 | 2016-04-14 |
| 1568864858 | Kathryn Hughlock | Nurse Practitioner | 4020 4th Ave, San Diego, CA 92103 | 2014-09-18 |
| 1730589953 | Morgan Wolf | Nurse Practitioner | 8935 Towne Centre Dr, San Diego, CA 92122-5651 | 2014-08-25 |
| Find all providers in SAN DIEGO | ||||
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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.