KELLEY C GOWDY (NPI# 1497083927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497083927 |
| Entity Type | Individual |
| Full Name | KELLEY C GOWDY |
| Credential | FNP-BC |
| Practice Address |
4711 Poplar Springs Drive Meridian MS 39305 |
| Mailing Address |
4711 Poplar Springs Dr Meridian MS 39305-2622 |
| Practice Telephone | 6016353333 |
| Practice Fax Number | 6016353333 |
| Mailing Telephone | 6015458700 |
| Mailing Fax Number | 6015825461 |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2011-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R860748 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04424823 | 05 |
| Street Address |
4711 POPLAR SPRINGS DRIVE |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521053 | Shirley Home Care, LLC | Nurse's Aide | 4525 Poplar Springs Drive, Meridian, MS 39305 | 2020-09-08 |
| 1871017855 | Robbyn Lee | Nurse Practitioner | 4715 24th Place, Meridian, MS 39305 | 2017-08-01 |
| 1245686575 | Synergy Physical Therapy & Sports Medicine, LLC | Clinic/Center | 2447 47th Court, Suite F, Meridian, MS 39305 | 2016-05-05 |
| 1912305988 | Anderson Regional Medical Center | Family Medicine | 6694 Poplar Springs Drive, Meridian, MS 39305 | 2014-12-08 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1982042198 | Kennerh Provine Collins | Pharmacist | 2917 56th Court, Meridian, MS 39305 | 2013-06-10 |
| 1306284880 | A1 In Home Therapy | Community Health Worker | 211 North Hills Street J6, A1 In Home Therapy, Meridian, MS 39305 | 2013-06-06 |
| 1497192876 | Taylor Farland | Dentist | 2300 North Hills, Meridian, MS 39305 | 2013-05-27 |
| 1376814533 | Priscilla Miller | Nurse Practitioner | 4715 42nd Place, Meridian, MS 39305 | 2012-01-19 |
| 1578757076 | Primary Eyecare & Optical of Meridian, P.a. | Optometrist | 4721 26th Ave., Meridian, MS 39305 | 2007-08-29 |
| Find all providers in zip 39305 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427152 | Christopher Alan Anthony Nicholas | Nurse Practitioner | 2889 N Chancery Pl, Meridian, ID 83646-7407 | 2020-11-05 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1649885534 | Auston Whitmer | Nurse Practitioner | 2203 E Ringneck St, Meridian, ID 83646-7410 | 2020-09-09 |
| 1407460157 | Kimberly N Lacap | Nurse Practitioner | 5961 Hwy 145, Meridian, MS 39301-9761 | 2020-09-01 |
| 1134733728 | Courtney S Dubose | Nurse Practitioner | 8252 Lizelia Rd, Meridian, MS 39305-8511 | 2020-09-01 |
| 1740890698 | Kimberly Parker | Nurse Practitioner | 4708 Hickory Hills Cir, Meridian, MS 39305-2440 | 2020-08-05 |
| 1396369138 | Tracy Ann Roberts | Nurse Practitioner | 3639 S Arno Ave, Meridian, ID 83642-1396 | 2020-06-06 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1285293639 | Lindsey Sand | Nurse Practitioner | 2347 E Gala St # 150, Meridian, ID 83642-4881 | 2019-06-10 |
| Find all providers in MERIDIAN | ||||
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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.