JASON KELLY (NPI# 1669785556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669785556 |
| Entity Type | Individual |
| Full Name | JASON KELLY |
| Credential | M.D. |
| Practice Address |
3000 32nd Ave S Fargo ND 58103-6132 |
| Mailing Address |
1901 Connecticut Ave S Sartell MN 56377-2554 |
| Practice Telephone | 7013648000 |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2018-05-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 58081 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | STATE BOARD | 58081 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831644251 | Jason Kelly | Spec/Tech, Cardiovascular | 7012 E Nelson Dr, Tucson, AZ 85730-1718 | 2016-08-16 |
| 1861034571 | Jason Lee Kelly | Pharmacist | 100 Walmart Dr, Kingwood, WV 26537-1143 | 2019-10-14 |
| 1811452378 | Jason P Kelly | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-02-08 |
| 1598050544 | Jason Kelly | Family Medicine | 9000 Bailey Cove Rd Se, Huntsville, AL 35802-4002 | 2011-06-17 |
| 1538399738 | Jason Stuart Kelly | Anesthesiology | 1250 S 18th St, Fernandina Beach, FL 32034-1902 | 2009-07-22 |
| 1346442159 | Jason Matthew Kelly | Pharmacist | 105 Mall Blvd, Monroeville, PA 15146-2230 | 2007-06-04 |
| 1033277876 | Jason Alexander Kelly | Family Medicine | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2006-12-05 |
| 1063590859 | Jason F. Kelly | Radiology | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-11-01 |
| 1073543831 | Jason Kelly | Radiology | 101 E Wood St, Spartanburg, SC 29303-3040 | 2006-07-04 |
| 1659324473 | Jason Kelly | Radiology | 501 E Hampden Ave, Englewood, CO 80113-2702 | 2006-05-19 |
| Street Address |
3000 32ND AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-6132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073506648 | Randy K Metcalf | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2005-08-29 |
| 1861006504 | Hallie M Tiffany | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-09-01 |
| 1144846452 | Andrea Patrice Solberg | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-23 |
| 1669098976 | Nathaniel James Piersol | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-23 |
| 1710503545 | Emily Olivia Miranda | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-17 |
| 1619500642 | Collin Docter | Physical Therapist | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-02-18 |
| 1386276863 | Corey David Bos | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-02-12 |
| 1619508587 | Stephanie Lee Piirainen | Student in an Organized Health Care Education/Training Program | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-01-30 |
| 1386274918 | Melissa Ann Knopik | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-01-23 |
| 1205475126 | Jerika A Decker | Physician Assistant | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2019-12-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366494809 | Philip Quentin Johnson | Orthopaedic Surgery | 2829 University Dr S, Suite 202, Fargo, ND 58103-6050 | 2006-05-16 |
| 1740540707 | John Rostad Haggart | Orthopaedic Surgery | 3000 32nd Ave S, Fargo, ND 58103 | 2012-05-24 |
| 1013282425 | Razvan Nicolescu | Orthopaedic Surgery | 3000 32nd Ave South, Fargo, ND 58103-6132 | 2012-03-19 |
| 1083981567 | Parth Ashok Vyas | Orthopaedic Surgery | 801 Broadway N, Fargo, ND 58102-3641 | 2011-11-28 |
| 1184917924 | Sanford Medical Center Fargo | Orthopaedic Surgery | 801 Broadway N, Fargo, ND 58102-3641 | 2011-05-26 |
| 1477846749 | Michael A White | Orthopaedic Surgery | 2301 25th St S, Fargo, ND 58103-6104 | 2011-05-19 |
| 1093005902 | Brian Sauer | Orthopaedic Surgery | 2301 25th St S, Fargo, ND 58103 | 2011-04-12 |
| 1326222514 | Benjamin Noonan | Orthopaedic Surgery | 2301 25th St S, Fargo, ND 58103-6104 | 2007-12-24 |
| 1356551089 | Kevin Dahl | Orthopaedic Surgery | 2301 25th St S, Fargo, ND 58103-6104 | 2007-05-23 |
| 1437167525 | George A Walker | Orthopaedic Surgery | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2006-08-04 |
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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.