SANDRA TRACEY KELLEY (NPI# 1699813212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699813212 |
| Entity Type | Individual |
| Full Name | SANDRA TRACEY KELLEY |
| Credential | NP |
| Practice Address |
845 Angliana Ave Lexington KY 40508-3146 |
| Mailing Address |
801 Forest Lake Dr Lexington KY 40515-6299 |
| Practice Telephone | 8593239321 |
| Mailing Telephone | 8592733774 |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2019-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1264 | KY | Behavioral Health & Social Service Providers |
| N | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
3003542 | KY | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3003542 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3107 Cincinnati Rd, Georgetown, KY 403249505 | 5025709313 | 5028677978 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558828954 | Sandra Kelley | Licensed Practical Nurse | 7919 Seward Ave, Cincinnati, OH 45231-3320 | 2019-02-22 |
| 1669685830 | Sandra Kelley | Physician Assistant | 823 Main St, Hope Valley, RI 02832-1920 | 2007-05-07 |
| 1598775207 | Sandra Kelley | Clinical Nurse Specialist | 1150 Varnum St Ne, Washington, DC 20017 | 2006-08-08 |
| 1699731679 | Sandra K Kelley | Nurse Practitioner | 1900 10th Ave, Suite 200, Columbus, GA 31901-3600 | 2006-04-26 |
| Street Address |
845 ANGLIANA AVE |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40508-3146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437186863 | Michelle Lofwall | Psychiatry & Neurology | 845 Angliana Ave, Lexington, KY 40508-3146 | 2006-06-28 |
| 1356817274 | Kentucky Medical Services Foundation, Inc | Psychiatry & Neurology | 845 Angliana Ave, Lexington, KY 40508-3146 | 2018-10-18 |
| 1720455462 | Robert Ian Moore II | Social Worker | 845 Angliana Ave, Lexington, KY 40508-3146 | 2015-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265906192 | Core Chiropractic and Family Wellness Pllc | Clinic/Center | 524 E.second St, Lexington, KY 40508 | 2019-01-14 |
| 1831669720 | Lily Namegabe | Community Health Worker | 135 Newtown Pike Bldg 1, Lexington, KY 40508 | 2018-12-04 |
| 1669994091 | Shawn Luchtefeld | Counselor | 289 W Loudon Ave, Lexington, KY 40508 | 2017-07-07 |
| 1861808271 | Rucha Shukla | Pediatrics | 138 Leader Ave Rm 9a, Lexington, KY 40508 | 2014-07-07 |
| 1881012946 | Peter Movilla | Obstetrics & Gynecology | Uk Women's Health Obstetrics and Gynecology, 125 E Maxwell St Ste 140, Lexington, KY 40508 | 2014-04-04 |
| 1255753422 | Candace Cross | Social Worker | Kentucky Counseling Center, LLC, 1353 West Main Street, Kentucky, Lexington, KY 40508 | 2014-01-07 |
| 1467896845 | Andrew Russell Roads | Psychiatry & Neurology | Uk University Health Service, 830 S Limestone, Lexington, KY 40508 | 2013-04-29 |
| 1104119890 | Thomas Michael Isaacs | Pharmacist | 130 W. Loudon Ave, Lexington, KY 40508 | 2011-05-27 |
| 1174839401 | Gerardo Manuel Heredia Melero | Obstetrics & Gynecology | Uk Obgyn, 125 E. Maxwell Street, Lexington, KY 40508 | 2010-08-24 |
| 1558512814 | Cortney Youens Lee | Surgery | 125 E. Maxwell St, Suite 302, Lexington, KY 40508 | 2008-10-06 |
| Find all providers in zip 40508 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225161 | Christina Chan Sok | Nurse Practitioner | 24 Hartwell Ave # 204, Lexington, MA 02421-3132 | 2020-11-05 |
| 1871194381 | Stacie Rose | Nurse Practitioner | 131 Hartwell Ave, Lexington, MA 02421-3105 | 2020-11-03 |
| 1952900870 | Sarah Elizabeth Clark | Nurse Practitioner | 1309 Morning Side Ct, Lexington, KY 40509-2353 | 2020-10-21 |
| 1629677745 | Lisa Elaine Coleman | Nurse Practitioner | 2241 Gulfstream Dr, Lexington, KY 40504-3273 | 2020-10-20 |
| 1578161303 | Mariem Kader | Nurse Practitioner | 3622 White Pine Dr, Lexington, KY 40514-1740 | 2020-10-14 |
| 1023616125 | Kimberly Dawn Calloway | Nurse Practitioner | 5306 E Blocher Rd, Lexington, IN 47138-8803 | 2020-10-12 |
| 1649878992 | Margaret Bunch | Nurse Practitioner | 171 W Lowry Ln Ste 132, Lexington, KY 40503-3006 | 2020-10-09 |
| 1831701572 | Jillian Leigh Butcher | Nurse Practitioner | 2917 Mahala Ln, Lexington, KY 40509-8555 | 2020-08-22 |
| 1033721154 | Heart Rescue Cpr LLC | Nurse Practitioner | 501 Darby Creek Rd Ste 18, Lexington, KY 40509-1606 | 2020-08-19 |
| 1619588241 | Jordyn L Bush | Nurse Practitioner | 124 Clay Ave, Lexington, KY 40502-1702 | 2020-08-17 |
| Find all providers in LEXINGTON | ||||
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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.