GLENN PATRICK KELLEY (NPI# 1417985813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417985813 |
| Entity Type | Individual |
| Full Name | GLENN PATRICK KELLEY |
| Credential | M.D. |
| Practice Address |
4200 Houma Blvd Fl 2 Metairie LA 70006-2970 |
| Practice Telephone | 5044544102 |
| Practice Fax Number | 5044544192 |
| Mailing Telephone | 5044544102 |
| Mailing Fax Number | 5044544192 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2016-12-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD.025489 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1575755 | 05 |
| Street Address |
4200 HOUMA BLVD FL 2 |
| City | METAIRIE |
| State | LA |
| Zip Code | 70006-2970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437786365 | Christina Alder Humble | Behavior Technician | 4201 N 1-10 Service Road W., Metairie, LA 70006 | 2020-03-23 |
| 1285270959 | Brittanie Renee Tank | Behavior Technician | 4201 N 1-10 Service Rd, W, Metairie, LA 70006 | 2019-11-18 |
| 1447896105 | Jacob Dent Dds Dentists of Metairie A Professional Corporation | Dentist | 5201 Veterans Memorial Blvd., Suite A, Metairie, LA 70006 | 2019-11-18 |
| 1417504861 | Caryn Tesia Washington | Behavior Technician | 4201 N 1-10 Service Rd W., Metarie, LA 70006 | 2019-08-21 |
| 1568023356 | Brittany Nicole Davis | Behavioral Analyst | 4201 N-i 10 Service Rd, Metairie, LA 70006 | 2019-06-24 |
| 1295393650 | Beth Ann Martin | Behavior Technician | 4201 N. Service Road W, Metairie, LA 70006 | 2019-05-31 |
| 1942866561 | Manunique Johnson | Behavior Technician | 4201 N-1-10 Service Rd W., Metairie, LA 70006 | 2019-05-20 |
| 1972068419 | Stacey R Phipps | Behavior Technician | 4201 N 1-10 Service Rd. W., Metairie, LA 70006 | 2019-02-08 |
| 1740752799 | Na'triana Clark | Behavior Technician | 4210 N I-10 Service Rd, Metairie, LA 70006 | 2018-12-31 |
| 1861969131 | Lauren Hay Hughes | Behavior Technician | 4201 N 1-10 Service Rd. West, Metairie, LA 70006 | 2018-10-25 |
| Find all providers in zip 70006 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1619952017 | William Airth Rolston IIi | Internal Medicine | 4224 Houma Blvd #450a, Metairie, LA 70006 | 2005-12-08 |
| 1851375281 | Lois Mailander | Internal Medicine | 4224 Houma Blvd Ste 500, Metairie, LA 70006-2938 | 2005-11-30 |
| 1780056903 | Limb Salvage Institute, LLC | Internal Medicine | 2520 Harvard Ave, Suite 2a, Metairie, LA 70001-1172 | 2015-10-27 |
| 1588836621 | Orlando Deffer | Internal Medicine | 4224 Houma Blvd Ste 500, Metairie, LA 70006-2938 | 2008-03-28 |
| 1912079120 | Nicholas Demeteius Pappas Jr. | Internal Medicine | 4224 Houma Blvd Ste 500, Metairie, LA 70006-2938 | 2006-11-14 |
| 1124064092 | Luis F Soto | Internal Medicine | 4300 Houma Blvd, Suite 107, Metairie, LA 70006 | 2006-06-21 |
| 1952342560 | Sangeeta B Shah | Internal Medicine | 2005 Veterans Memorial Blvd, Metairie, LA 70002-6320 | 2006-06-08 |
| 1578521605 | Homeyar K Dinshaw | Internal Medicine | 2005 Veterans Memorial Blvd, Metairie, LA 70002-6320 | 2006-05-01 |
| 1235196106 | Patrick C. Breaux | Internal Medicine | 2005 Veterans Memorial Blvd, Metairie, LA 70002-6320 | 2006-04-26 |
| 1881678589 | Roland J Bourgeois Jr. | Internal Medicine | 4224 Houma Blvd, Suite 500, Metairie, LA 70006-2933 | 2005-12-06 |
| Find all providers in METAIRIE | ||||
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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.