DANIEL KELLY (NPI# 1417480831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417480831 |
| Entity Type | Individual |
| Full Name | DANIEL KELLY |
| Credential | MD |
| Practice Address |
2500 N State St Jackson MS 39216-4500 |
| Practice Telephone | 6019845607 |
| Practice Fax Number | 6019846665 |
| Mailing Telephone | 6019845607 |
| Mailing Fax Number | 6019846665 |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134513146 | Daniel Kelly | Dentist | 2301 W Sample Rd Ste 7b, Pompano Beach, FL 33073-3081 | 2015-03-27 |
| 1528100047 | Daniel Reirdon Kelly | Dentist | 905 Rio East Court, Suite B, Charlottesville, VA 22901 | 2007-02-12 |
| 1386748382 | Daniel L Kelly | Dentist | 2401 S Washington St, Suite B, Grand Forks, ND 58201-6747 | 2006-09-11 |
| 1770548265 | Daniel Joseph Kelly | Ophthalmology | 405 E 7th St, The Dalles, OR 97058-2607 | 2006-04-19 |
| 1922089556 | Daniel R Kelly | Family Medicine | 701 Randolph St Ste 120, Radford, VA 24141-3047 | 2005-11-10 |
| 1770133803 | Daniel James Kelly | Social Worker | 12 Union St, Rockland, ME 04841-2739 | 2019-09-20 |
| 1265082168 | Daniel Richard Kelly | Nurse Practitioner | 6565 Fannin St, Houston, TX 77030-2703 | 2019-09-13 |
| 1386120541 | Daniel Clark Kelly | Counselor | 6753 State Rd, Parma, OH 44134-4517 | 2018-07-11 |
| 1194061390 | Daniel Brian Kelly | Physical Therapist | 129 W 36th St, Erie, PA 16508-2903 | 2012-12-17 |
| 1154689917 | Daniel Joseph Kelly | Family Medicine | 940 Hesters Crossing Rd, Round Rock, TX 78681-8018 | 2012-04-30 |
| Street Address |
2500 N STATE ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556231 | University Ophthalmology Associates | Ophthalmology | 2500 N State St, Ste B329, Jackson, MS 39216-4500 | 2005-05-24 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1679189849 | Raegan Wilson | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-22 |
| 1851905095 | Violet Maloba Awori | Student in an Organized Health Care Education/Training Program | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-04 |
| 1295348639 | Kassidy Voinche | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-25 |
| 1215549423 | Brittney Leeann Williams | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-19 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1982215414 | Anita Dhanrajani | Pediatrics | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-10 |
| 1528676954 | Nicholas Mcafee | Psychologist | 2500 N State St, Jackson, MS 39216-4500 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851407 | Rebecca Lynn Collimore | Student in an Organized Health Care Education/Training Program | 5 Twin Oaks Ct, Jackson, NJ 08527-5359 | 2020-11-05 |
| 1578176053 | Breanna Christina Wade | Student in an Organized Health Care Education/Training Program | 1647 Robinson St Apt B, Jackson, MS 39209-6424 | 2020-08-25 |
| 1730798240 | Taylor Michael Smith | Student in an Organized Health Care Education/Training Program | 21 Windfield Cv, Jackson, TN 38305-9778 | 2020-07-30 |
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1922620855 | Madison K Heine | Student in an Organized Health Care Education/Training Program | Univ. of Mississippi Medical Center, School of Dentistry, Jackson, MS 39216-3921 | 2020-05-14 |
| 1083236210 | Juvell Nicole Burris | Student in an Organized Health Care Education/Training Program | 802 Lakeland Dr Apt 104, Jackson, MS 39216-4613 | 2020-05-11 |
| 1316569742 | Monieca Michelle Mcnair | Student in an Organized Health Care Education/Training Program | 635 Nakoma Dr, Jackson, MS 39206-3335 | 2020-05-07 |
| 1760011480 | Kandice Bailey | Student in an Organized Health Care Education/Training Program | 915 Bellevue Pl, Jackson, MS 39202-2702 | 2020-04-04 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| Find all providers in JACKSON | ||||
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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.