TYLER KELLY (NPI# 1689100935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689100935 |
| Entity Type | Individual |
| Full Name | TYLER KELLY |
| Credential | DO |
| Practice Address |
101 Dates Dr Ithaca NY 14850-1342 |
| Practice Telephone | 6072744011 |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2020-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 301771 | NY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 507 Main St, Johnson City, NY 137901810 | 6077636075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639401151 | Tyler Justin Kelly | Chiropractor | 815 Grandview Ave, Ste 250, Columbus, OH 43215-1254 | 2010-02-09 |
| 1336667419 | Tyler R Kelly | Physical Therapy Assistant | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2017-09-08 |
| 1962818864 | Tyler P Kelly | Nurse Practitioner | 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471 | 2014-07-11 |
| 1023458478 | Tyler J. Kelly | Podiatrist | 225 Crosslake Dr, Evansville, IN 47715-8198 | 2013-06-30 |
| Street Address |
101 DATES DR |
| City | ITHACA |
| State | NY |
| Zip Code | 14850-1342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861498602 | John-paul Daniel Mead | Internal Medicine | 101 Dates Dr, Ithaca, NY 14850-1342 | 2005-06-27 |
| 1447865258 | Erin Constance Griffeth | Registered Nurse | 101 Dates Dr, Ithaca, NY 14850-1342 | 2020-09-09 |
| 1164033619 | Julia Shats | Occupational Therapist | 101 Dates Dr, Ithaca, NY 14850-1342 | 2020-08-10 |
| 1033744891 | Suzanne Dozoretz | Nurse Practitioner | 101 Dates Dr, Ithaca, NY 14850-1342 | 2020-03-11 |
| 1710524616 | Kevin Patrick Jones | Nurse Practitioner | 101 Dates Dr, Ithaca, NY 14850-1342 | 2019-12-10 |
| 1154963544 | Bagum Karimullah Gulshad | Nurse Practitioner | 101 Dates Dr, Ithaca, NY 14850-1383 | 2019-10-17 |
| 1841832219 | Caitlin Paulson | Physical Therapy Assistant | 101 Dates Dr, Ithaca, NY 14850-1383 | 2019-10-17 |
| 1295398048 | Ian C Sutton | Physician Assistant | 101 Dates Dr, Ithaca, NY 14850 | 2019-04-17 |
| 1912471947 | Rebecca O'keefe | Physician Assistant | 101 Dates Dr, Ithaca, NY 14850-1383 | 2019-01-12 |
| 1780157958 | Jill Mayer | Physical Therapist | 101 Dates Dr, Ithaca, NY 14850-1342 | 2019-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123897 | Michelle Lee Sanito | Registered Nurse | 400 Lake Street, Ithaca, NY 14850 | 2020-10-30 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1518581701 | Sameer Acharya | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-03 |
| 1699399873 | Anurag Aryal | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Internal Medicine Residency, Cayuga Med, Ithaca, NY 14850 | 2020-06-03 |
| 1932723228 | Binay Kumar Kshetree | Student in an Organized Health Care Education/Training Program | Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-02 |
| 1225657349 | Nima Hazrati Pour Fard | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Cayuga Medical Center, 101, Ithaca, NY 14850 | 2020-04-09 |
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1609407709 | En-ting Hsu | Marriage & Family Therapist | 110 N. Cayuga Street 4th Floor Suite 3, Ithaca, NY 14850 | 2020-01-28 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1538722343 | Priyesh Thakurathi | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Cayuga Medical Center, Internal Medicine Residency Program, Ithaca, NY 14850 | 2019-04-17 |
| Find all providers in zip 14850 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790339406 | Isabella Citizens for Health, Inc. | Family Medicine | 400 Webster St, Ithaca, MI 48847-1818 | 2019-07-31 |
| 1548814510 | Isabella Citizens for Health, Inc. | Family Medicine | 710 N Union St, Ithaca, MI 48847-1314 | 2019-07-29 |
| 1891104899 | Nine Rivers Osteopathy PC | Family Medicine | 200 Pleasant Grove Rd Ste 6, Ithaca, NY 14850-2664 | 2014-08-05 |
| 1568742914 | Carol Thuytien Berlin | Family Medicine | 209 West State Street, Ithaca, NY 14850 | 2011-08-17 |
| 1700036654 | Susan Beith Soboroff | Family Medicine | 220 S Fulton St, Ithaca, NY 14850-3306 | 2008-09-29 |
| 1467621797 | Progressive Medicine of Ithaca, PC | Family Medicine | 402 3rd Street, Suite 2, Ithaca, NY 14850 | 2008-02-20 |
| 1619001641 | Dorothy P Ambis | Family Medicine | 208 Texas Ln, Ithaca, NY 14850-1757 | 2007-03-14 |
| 1801922919 | Marne Oshae | Family Medicine | 4 Sanctuary Dr # 2, Ithaca, NY 14850-1976 | 2007-02-25 |
| 1801981402 | Christine Vivian Lorenzo | Family Medicine | 953 Danby Road, Hammond Health Center - Ithaca College, Ithaca, NY 14850 | 2006-10-03 |
| 1487694469 | Mary Jane Welch | Family Medicine | 840 Hanshaw Road, Asthmas & Allergy Associates P.C., Ithaca, NY 14850 | 2006-06-07 |
| Find all providers in ITHACA | ||||
Please comment or provide details below to improve the information on TYLER KELLY.
| 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.