KELLY G COUGHLIN (NPI# 1679923601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679923601 |
| Entity Type | Individual |
| Full Name | KELLY G COUGHLIN |
| Credential | PA |
| Practice Address |
6716 Nw 11th Place Ste 200 Gainesville FL 32605-4215 |
| Practice Telephone | 3523319729 |
| Mailing Telephone | 3523319729 |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2017-04-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9109645 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 5DKRV | 01 |
| FL | RAILROAD MEDICARE | P01721293 | 01 |
| FL | RAILROAD MEDICARE | P01721294 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718347 | Kelly Coughlin | Student in an Organized Health Care Education/Training Program | 1001 Main St Fl 5, Buffalo, NY 14203-1009 | 2020-04-06 |
| 1124018676 | Kelly J Coughlin | Dietitian, Registered | 49725 County 83, Staples, MN 56479-5280 | 2005-10-26 |
| Street Address |
6716 NW 11TH PLACE STE 200 |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32605-4215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374551 | Mark F Patlovich | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2005-05-24 |
| 1235494170 | Robert Andrew Mackey | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2012-07-06 |
| 1073873949 | Michael L Gray | Physician Assistant | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2012-05-24 |
| 1013142983 | Rati N Patel | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2009-05-21 |
| 1336345248 | Wesley B Mann | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2007-06-26 |
| 1376746438 | Manish L Jani | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2007-06-07 |
| 1669482865 | Adam V Ping | Physician Assistant | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2006-08-09 |
| 1528098555 | Frank Anthony Fiola | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2006-07-04 |
| 1619923984 | Harry Kevin Meisenbach | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2006-05-26 |
| 1922051374 | Adam Carl Means | Radiology | 6716 Nw 11th Place, Ste 200, Gainesville, FL 32605-4215 | 2006-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205435 | Remy Fadel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terr, Gainsville, FL 32605 | 2020-05-05 |
| 1518528652 | Family Restoration Station Counseling Center, LLC | Marriage & Family Therapist | 912 Nw 56th Terr, Suite A, Gainesville, FL 32605 | 2019-06-27 |
| 1568925105 | Ryeisha Hough | Behavior Technician | 1051 Sw 56 Terrace, Gainesville, FL 32605 | 2019-04-10 |
| 1003308040 | Titan Mri LLC | Clinic/Center | 919 Nw 57th St Ste 20, Gainesville, FL 32605 | 2018-06-05 |
| 1922598432 | Angela Maria Fernandez Manovel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terrace, Gainesville, FL 32605 | 2018-05-10 |
| 1396235800 | Aya Marachi | Student in an Organized Health Care Education/Training Program | 6500 W. Newberry Rd., Gainesville, FL 32605 | 2018-05-10 |
| 1053813543 | Jaime L Jasser | Counselor | 2240 Nw 40th Terrace Ste A, Gainesville, FL 32605 | 2018-03-01 |
| 1164932901 | Anesthesia Physician Solutions of North Florida, LLC | Anesthesiology | 6500 W Newberry Road, Gainesville, FL 32605 | 2017-10-06 |
| 1336667930 | Zina Theresse Durr | Adult Companion | 3124 Nw 29th Place, Gainesville, FL 32605 | 2017-09-03 |
| 1982126306 | Crystal Thompson Baumann | Nurse Practitioner | 6440 W Newberry Rd Ste 409, Gainesville, FL 32605 | 2017-07-07 |
| Find all providers in zip 32605 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316417181 | Elizabeth H Yun | Physician Assistant | 7500 Iron Bar Ln Ste 215, Gainesville, VA 20155-3612 | 2018-12-04 |
| 1558666784 | Yanira Serralta | Physician Assistant | 4410 W Newberry Rd Ste 3, Gainesville, FL 32607-5200 | 2011-01-19 |
| 1912054578 | David A. Kireta | Physician Assistant | 4340 Newberry Rd, Suite 301, Gainesville, FL 32607-2557 | 2007-01-05 |
| 1306911375 | North Florida Neurosurgery | Physician Assistant | 6510 Nw 9th Blvd Ste 1, Gainesville, FL 32605-4245 | 2006-11-22 |
| 1366530610 | Andrew F Roush | Physician Assistant | 200 Academy Street, Gainesville, GA 30501 | 2006-10-11 |
| 1003907445 | William R Wright | Physician Assistant | 4343 W. Newberry Road, Suite 13, Gainesville, FL 32607 | 2006-09-28 |
| 1235237165 | Elizabeth Courtney Wilhem | Physician Assistant | 4741 Nw 8th Ave Ste C, Gainesville, FL 32605-5511 | 2006-09-21 |
| 1265445324 | Joy Steinkraus | Physician Assistant | 743 Spring Street Ne, Gainesville, GEORGIA 30501 | 2006-08-13 |
| 1225053572 | Julie Ann Hopper | Physician Assistant | 2435 Old Cornelia Hwy, Gainesville, GA 30507-7854 | 2006-07-13 |
| 1053346296 | Audrey B Gibson | Physician Assistant | 961 Smoky Mountain Springs Lane Ne, Ste A, Gainesville, GA 30501 | 2006-07-12 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32605 |
Please comment or provide details below to improve the information on KELLY G COUGHLIN.
| 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.