TIMOTHY G KELLY (NPI# 1497758825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497758825 |
| Entity Type | Individual |
| Full Name | TIMOTHY G KELLY |
| Credential | M.D. |
| Practice Address |
1915 Tradd Ct Wilmington NC 28401-6638 |
| Mailing Address |
1915 Tradd Court Wilmington NC 28401-6638 |
| Practice Telephone | 9107620057 |
| Practice Fax Number | 9107620336 |
| Mailing Telephone | 9107620057 |
| Mailing Fax Number | 9107620336 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2013-10-18 |
| NPI Deactivation Date | 03/20/2006 |
| NPI Reactivation Date | 2006-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 33074 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | UNITED HEALTHCARE | 0838871 | 01 |
| NC | BCBS | 0210J | 01 |
| NC | 890210J | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720561608 | Timothy Kelly | Social Worker | 25a Vreeland Rd, Florham Park, NJ 07932-1910 | 2018-09-07 |
| 1942525928 | Timothy Anton Kelly | Home Health | 7954 Brooklyn Boulavard, 7954, Brooklyn Park, MN 55445 | 2010-04-01 |
| 1003026261 | Timothy Richard Kelly | Psychiatry & Neurology | 510 Azalea Dr Ste 200, Oxford, MS 38655-6903 | 2007-05-23 |
| 1700953163 | Timothy James Kelly | Chiropractor | 1038 Washington Street, Fairfield, CA 94533-5545 | 2006-11-29 |
| 1063592558 | Timothy P Kelly | Chiropractor | 3098 Piedmont Rd Ne Ste 430, Atlanta, GA 30305-2600 | 2006-10-17 |
| 1588653281 | Timothy Lynn Kelly | Dentist | 1600 Mountain View Rd, Suite 104, Rapid City, SD 57702-4381 | 2005-10-17 |
| 1992798169 | Timothy L Kelly | Anesthesiology | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2005-08-23 |
| 1073140497 | Timothy Stephen Kelly | Student in an Organized Health Care Education/Training Program | 1 Gustave L Levy Pl # 1149, New York, NY 10029-6504 | 2020-03-25 |
| 1649805888 | Timothy Dwyer Kelly | Student in an Organized Health Care Education/Training Program | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2020-03-09 |
| 1518590629 | Timothy Kelly | Peer Specialist | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-02-17 |
| Street Address |
1915 TRADD CT |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-6638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366404261 | Coastal Cape Fear Eye Associates, Pa | Ophthalmology | 1915 Tradd Ct, Wilmington, NC 28401-6638 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263566 | Center for Advanced Eye Care | Ophthalmology | 5301 Limestone Rd Ste 122, Wilmington, DE 19808-1251 | 2020-04-07 |
| 1205249539 | Ochsner Eye, Pa | Ophthalmology | 700 Military Cutoff Rd, Suite 202, Wilmington, NC 28405-8380 | 2014-06-04 |
| 1386994259 | John Wahl | Ophthalmology | 1904 Dorcas Ln, Wilmington, DE 19806-1164 | 2012-09-18 |
| 1669784849 | John Mcinnes | Ophthalmology | 424 Marianna Dr, Wilmington, DE 19803-1815 | 2010-07-05 |
| 1548406242 | David C Larned Md Pa | Ophthalmology | 2300 Pennsylvania Ave Ste 3a, Wilmington, DE 19806-1379 | 2008-12-30 |
| 1457513640 | Stephen Hein | Ophthalmology | 3039 W State Route 73, Wilmington, OH 45177-9287 | 2008-06-28 |
| 1174797666 | Carolina Glaucoma Pa | Ophthalmology | 1907 S 17th St Ste 3, Wilmington, NC 28401-6656 | 2008-04-16 |
| 1306937768 | Kathleen C Leone | Ophthalmology | 1729 New Hanover Medical Park Drive, Wilmington, NC 28403 | 2006-09-28 |
| 1306945795 | Frederick Clarence Butler Jr. | Ophthalmology | 3749 Reston Ct, Wilmington, NC 28403-6170 | 2006-09-21 |
| 1821107772 | Mary Elizabeth Price | Ophthalmology | 1907 S 17th Street, Suite 3, Wilmington, NC 28401-6656 | 2006-08-30 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
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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.