DAVID M KELLEY (NPI# 1417112442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417112442 |
| Entity Type | Individual |
| Full Name | DAVID M KELLEY |
| Credential | MD |
| Practice Address |
8348 Washington Ave Racine WI 53406-3733 |
| Practice Telephone | 2628844000 |
| Practice Fax Number | 7082455604 |
| Mailing Telephone | 2628844000 |
| Mailing Fax Number | 7082455604 |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2013-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 56165 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 125054284 | IL | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992302277 | David Andrew Kelley I | Pharmacist | 5816 Osage Beach Pkwy Ste 104, Osage Beach, MO 65065-3046 | 2020-10-08 |
| 1598175481 | David Kelley Sr. | Pharmacist | 4475 24th Ave., Fort Gratiot, MI 48059 | 2014-05-01 |
| 1053633305 | David M Kelley | Physical Therapist | 31 Williamstown Road, Lanesboro, MA 01237 | 2010-02-26 |
| 1427121714 | David R Kelley | Urology | 100 Wason Anenue, Suite 120, Springfield, MA 01107-1119 | 2006-11-16 |
| 1083796478 | David Baker Kelley | Internal Medicine | 408 Lilly Rd Ne Ste C, Olympia, WA 98506-6954 | 2006-10-19 |
| 1184720088 | David J. Kelley | Psychologist | 632 Plank Rd, Suite 209, Clifton Park, NY 12065 | 2006-09-16 |
| 1174565121 | David B Kelley | Psychologist | 1010 Fir Ln, Lockhart, TX 78644-2059 | 2006-06-12 |
| 1750367017 | David W. Kelley | Nurse Anesthetist, Certified Registered | 708 E Marshall St, West Chester, PA 19380-4413 | 2005-12-19 |
| 1447778774 | David C Kelley | Social Worker | 50 Moody St, Saco, ME 04072-1536 | 2017-09-07 |
| 1174830368 | David Kelley | Counselor | 17 Masonic St, Rockland, ME 04841-2808 | 2010-09-09 |
| Street Address |
8348 WASHINGTON AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53406-3733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407049505 | Sarada Vemareddy | Family Medicine | 8348 Washington Ave, Racine, WI 53406-3733 | 2007-08-22 |
| 1316157563 | Danielle Davis | Physical Therapist | 8348 Washington Ave, Racine, WI 53406-3733 | 2007-05-23 |
| 1770793960 | Eloise Frey | Physical Therapist | 8348 Washington Ave, Racine, WI 53406-3733 | 2007-05-23 |
| 1114137320 | Tammy R Magnuson | Occupational Therapist | 8348 Washington Ave, Racine, WI 53406-3733 | 2007-05-23 |
| 1710197926 | Melissa Johnson | Physical Therapy Assistant | 8348 Washington Ave, Racine, WI 53406-3733 | 2007-05-23 |
| 1184834301 | Susan K Rosenbaum | Physical Therapist | 8348 Washington Ave, Racine, WI 53406-3733 | 2007-05-23 |
| 1730238965 | Mark Ines | Family Medicine | 8348 Washington Ave, Racine, WI 53406-3733 | 2007-01-09 |
| 1669534582 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 8348 Washington Ave, Racine, WI 53406-3733 | 2006-12-15 |
| 1891802153 | Terry G Romana | Physician Assistant | 8348 Washington Ave, Racine, WI 53406 | 2006-08-24 |
| 1427165612 | Mahmood S Shaikh | Family Medicine | 8348 Washington Ave, Racine, WI 53406 | 2006-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215248927 | Andrew M Asbury | Family Medicine | 2408 Four Mile Rd, Racine, WI 53402 | 2010-06-28 |
| 1104144781 | Manmeet K Bains | Family Medicine | 3807 Spring Street, Racine, WI 53405-1667 | 2010-05-06 |
| 1073714127 | Melchor F Vidal Md Pllc | Family Medicine | Corner Rt 3 and 94, Racine, WV 25165 | 2007-05-29 |
| 1346467883 | Maurice Krashin | Family Medicine | 75 S Vincennes Cir, Racine, WI 53402-3660 | 2007-04-19 |
| 1407926280 | Chung-yen Philip Hsu | Family Medicine | 4215 Erie St, Suite 626, Racine, WI 53402-2899 | 2006-11-08 |
| 1033288816 | Northwestern Medical Center Sc | Family Medicine | 1532 S Green Bay Rd, Suite 200, Racine, WI 53406-4410 | 2006-11-07 |
| 1053341065 | Jennifer J. Brittig | Family Medicine | 2408 4 Mile Rd, Racine, WI 53402-2091 | 2006-07-04 |
| 1982632022 | Douglas D. Hunter | Family Medicine | 207 5th Street, Racine, OH 45771 | 2006-06-29 |
| 1992757744 | Gary L Shepherdson | Family Medicine | Mcw & All Saints Health Care System, 1320 Wisconsin Ave., Racine, WI 53403 | 2006-05-17 |
| 1033119276 | John A Martini | Family Medicine | 3805b Spring St, Ste 250, Racine, WI 53405-1641 | 2005-07-29 |
| Find all providers in RACINE | ||||
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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.