KELLY LAKIS (NPI# 1639696867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639696867 |
| Entity Type | Individual |
| Full Name | KELLY LAKIS |
| Credential | NP-C |
| Practice Address |
1800 Camelot Dr Ste 300 Virginia Beach VA 23454-2440 |
| Mailing Address |
230 Clearfield Ave Ste 124 Virginia Beach VA 23462-1832 |
| Practice Telephone | 7573213300 |
| Mailing Telephone | 7573213383 |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 95065961 | VA | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 0024175463 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1975 Glenn Mitchell Dr Ste 200, Virginia Beach, VA 234560167 | 7573213300 | 7573213330 |
| 272 Bendix Rd, Virginia Beach, VA 234521367 | 7574907545 |
| Street Address |
1800 CAMELOT DR STE 300 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-2440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578821872 | Jonathan William Strand | Physical Medicine & Rehabilitation | 1800 Camelot Dr Ste 300, Virginia Beach, VA 23454-2440 | 2012-04-25 |
| 1528688694 | Amy Beth Petersen | Nurse Practitioner | 1800 Camelot Dr Ste 300, Virginia Beach, VA 23454-2440 | 2020-04-19 |
| 1245685247 | Gary Brinkley Jr. | Physician Assistant | 1800 Camelot Dr Ste 300, Virginia Beach, VA 23454-2440 | 2016-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003455122 | Tonja Marie Devolgado | Nurse Practitioner | 2075 Glenn Mitchell Dr Ste 512, Virginia Beach, VA 23456-0179 | 2020-01-06 |
| 1720543069 | Erika Nicole Henson Miller | Nurse Practitioner | 307 Garcia Dr, Virginia Beach, VA 23454-4804 | 2019-01-31 |
| 1417432360 | Rosalyn Barberan | Nurse Practitioner | 4360 Shore Dr, Virginia Beach, VA 23455-2994 | 2018-09-26 |
| 1013422302 | Keisha Monique Baxter | Nurse Practitioner | 770 Lynnhaven Pkwy Ste 240, Virginia Beach, VA 23452-7324 | 2017-12-07 |
| 1184024911 | Deborah Lynn Wainwright | Nurse Practitioner | 502 Viking Dr Ste 200, Virginia Beach, VA 23452-7316 | 2014-08-29 |
| 1407105380 | Jamie Leigh Sustakoski | Nurse Practitioner | 1181 First Colonial Rd Ste 200, Virginia Beach, VA 23454-2437 | 2012-09-06 |
| 1285864868 | Elizabeth Gray Uzzle | Nurse Practitioner | 1100 Taylor Rd, Virginia Beach, VA 23464-4080 | 2009-07-17 |
| 1235322439 | Nancy Lynn Hopkins | Nurse Practitioner | 4867 Baxter Rd Ste 105, Virginia Beach, VA 23462-4469 | 2007-08-21 |
| 1700812344 | Lynn J Berkhimer | Nurse Practitioner | 5501 Greenwich Rd, Suite 200, Virginia Beach, VA 23462-6540 | 2006-06-24 |
| 1063460780 | Nina E Ramsey | Nurse Practitioner | 1708 Old Donation Parkway, Virginia Beach, VA 23454-3064 | 2006-05-05 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
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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.