TINA MARIE KELLY


Address: 433 Copperfield Blvd Ne, Concord, NC 28025-2405
Phone: 7047867770

TINA MARIE KELLY (NPI# 1518253251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518253251
Entity Type Individual
Full Name TINA MARIE KELLY
Credential FNP-C
Practice Address 433 Copperfield Blvd Ne
Concord
NC 28025-2405
Mailing Address 1300 Baxter St
Ste 215
Charlotte
NC 28204-3053
Practice Telephone 7047867770
Practice Fax Number 7049710035
Mailing Telephone 7043320396
Mailing Fax Number 7049710035
Enumeration Date 2011-06-21
Last Update Date 2015-07-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 5005521 NC Physician Assistants & Advanced Practice Nursing Providers
N 363L00000X Nurse Practitioner 17538 SC Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC 7006561 05

Other Providers TINA KELLY

NPI Name Taxonomy Address Enumeration
1295364115 Tina M. Kelly Behavior Technician 145 Moreland Ave, Waterbury, CT 06705-2928 2020-04-02
1073066908 Tina Kelly Occupational Therapist 21 Brittany Blvd, Marlton, NJ 08053-5513 2016-07-27
1629577721 Tina Marie Kelly Dental Hygienist 427 N Michigan Ave, Saginaw, MI 48602-4314 2018-02-05
1407219355 Tina Marie Kelly Marriage & Family Therapist 1144 Sonoma Ave, Suite 104, Santa Rosa, CA 95405-4812 2016-03-29
1104014455 Tina Vu Kelly Optometrist 3223 Duke St, Suite B3, Alexandria, VA 22314-4586 2007-10-11

Office Location

Street Address 433 COPPERFIELD BLVD NE
City CONCORD
State NC
Zip Code 28025-2405

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477550440 John Stephen Gerig Internal Medicine 433 Copperfield Blvd Ne, Concord, NC 28025-2405 2005-07-05
1053758714 Mona Walid Shaban Internal Medicine 433 Copperfield Blvd Ne, Concord, NC 28025-2405 2013-06-04
1750549721 Mehul Balubhai Patel Internal Medicine 433 Copperfield Blvd Ne, Concord, NC 28025-2405 2008-05-27
1902900301 Charles Edward Stoddard IIi Internal Medicine 433 Copperfield Blvd Ne, Concord, NC 28025-2405 2006-09-07
1043223977 Ernest F Johnson IIi Internal Medicine 433 Copperfield Blvd Ne, Concord, NC 28025-2405 2006-08-14
1508863465 Rebecca O Morton Nurse Practitioner 433 Copperfield Blvd Ne, Concord, NC 28025-2405 2005-07-06
1073510046 Nathan Ashley Woolwine Internal Medicine 433 Copperfield Blvd Ne, Concord, NC 28025-2405 2005-07-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053910729 Renewed Mindset Therapeutic Services, Pllc Social Worker 349 Copperfield Blvd Suite L #334, Concord, NC 28025 2020-10-22
1194284380 Carolinas Physicians Network Inc Internal Medicine 610 Alfred Brown Jr. Court, Concord, NC 28025 2019-03-18
1164913596 Damarius Raymond Faggart Counselor 503 Amhurst Drive, Concord, NC 28025 2018-05-22
1437677085 Kathryn Emily Kanauer Counselor 280 Executive Park Dr Ne, Concord, NC 28025 2017-09-05
1649794439 Foster Health & Homecare, LLC Home Health 363 Church Street North, Suite 260-i, Concord, NC 28025 2017-08-02
1326569336 Jessie Leigh Tilley-compton Social Worker 371 Amhurst St Sw, Concord, NC 28025 2017-06-29
1609305663 Sarah Katherine Thompson Licensed Practical Nurse 248 Executive Park Dr, Concord, NC 28025 2017-06-05
1023463098 Kiera Brown Social Worker 219 Lephillip Court, Concord, NC 28025 2016-04-27
1992169445 Brittiny N. Ingram Vanterpool Counselor 250 Branchview Dr Sw, Concord, NC 28025 2016-04-11
1215399852 The Charlotte-mecklenburg Hospital Authority Clinic/Center 840 Warren C. Coleman Blvd, Concord, NC 28025 2016-03-23
Find all providers in zip 28025

Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891355970 Taquita Shanee Milner Nurse Practitioner 3116 Dylan Pl Nw, Concord, NC 28027-0769 2019-06-19
1083182992 Katie Weatherman Tucker Nurse Practitioner 1085 Ne Gateway Ct Ne Ste 180, Concord, NC 28025-2407 2018-11-08
1174938799 Altegra Health Connections, LLC Nurse Practitioner 9 Capitol St, Concord, NH 03301-6310 2014-06-23
1548514888 Sarah Adler-mcdonald Nurse Practitioner 2000 Sierra Rd., Concord, CA 94518 2012-11-08
1982990560 Rashida Petrovich Nurse Practitioner 2222 East St # 305, Concord, CA 94520-2066 2011-06-22
1386774545 Deborah Ann Sampson Nurse Practitioner 60 Commerce St Suite 302, Concord Hospital Occupational Health, Concord, NH 03301-0000 2007-03-06
1164569307 Bridget Mary Canty Nurse Practitioner 5299 Laurel Dr, Concord, CA 94521-1529 2007-01-30
1679610844 Debra Lynn Knuckles Nurse Practitioner 855 Bradley St, Ste. A, Concord, NC 28025-2979 2007-01-30
1043375090 Kimberly A Capello Nurse Practitioner 59 Old Road To 9 Acre Cor, Ste 1, Concord, MA 01742-3317 2006-12-27
1346253978 My Linh Thi Waldrop Nurse Practitioner 9614 Camden Town Dr Nw, Concord, NC 28027-3332 2006-08-14
Find all providers in CONCORD

Competitor

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City CONCORD
Zip Code 28025

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Dataset Information

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.

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