DR. KELLY FEGAN-BOHM (NPI# 1730470139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730470139 |
| Entity Type | Individual |
| Full Name | DR. KELLY FEGAN-BOHM |
| Credential | M.D. |
| Practice Address |
6701 Fannin St Houston TX 77030-2608 |
| Mailing Address |
2450 Holcombe Blvd Ste Nb-34l Houston TX 77021-2039 |
| Practice Telephone | 8328241000 |
| Mailing Telephone | (832) 828-3660 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2017-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
R3670 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
6701 FANNIN ST |
| City | HOUSTON |
| State | TX |
| Zip Code | 77030-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729897 | Ellen M. Friedman | Otolaryngology | 6701 Fannin St, Ste 540, Houston, TX 77030-2316 | 2005-06-09 |
| 1659996882 | Nohemi Garcia | Counselor | 6701 Fannin St, Houston, TX 77030-2608 | 2020-06-12 |
| 1801416326 | Rachelle Gerke | Nurse Anesthetist, Certified Registered | 6701 Fannin St, Houston, TX 77030-2608 | 2020-04-24 |
| 1962039560 | Carolina Coronel Bertero | Social Worker | 6701 Fannin St, Houston, TX 77030-2608 | 2020-03-24 |
| 1710511209 | Fumiya Yoneyama | Surgery | 6701 Fannin St, Houston, TX 77030-2608 | 2020-02-24 |
| 1952934853 | Erin Alycia Basile | Nurse Practitioner | 6701 Fannin St, Houston, TX 77030-2608 | 2020-02-19 |
| 1194358358 | Ashley Lynn Brenner | Nurse Practitioner | 6701 Fannin St, Houston, TX 77030-2608 | 2020-02-17 |
| 1316587108 | Megan Mckinney Williams | Nurse Anesthetist, Certified Registered | 6701 Fannin St, Houston, TX 77030-2608 | 2020-01-09 |
| 1205475985 | Taylor Ann Matson | Physician Assistant | 6701 Fannin St, Houston, TX 77030-2608 | 2019-12-30 |
| 1972140259 | Haley Aydam Lattal | Nurse Practitioner | 6701 Fannin St, Houston, TX 77030-2608 | 2019-12-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770852 | Mchaji Celestaine | Pharmacist | Medvamc 2002 Holcombe Blvd, Outpatient Pharmacy, Houston, TX 77030 | 2020-11-04 |
| 1730702598 | Christopher A Mcmillian | Student in an Organized Health Care Education/Training Program | Houston Methodist Department of Surgery, 6550 Fannin St., Smith Tower 1661, Houston, TX 77030 | 2020-05-27 |
| 1245852698 | Mostafa Hotait | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street 9a, Houston, TX 77030 | 2020-05-08 |
| 1790307288 | Ayushi Jayesh Shah | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Department of Neurology, Houston Method, Suite 802, Scurlock. 8thfloor, Houston, TX 77030 | 2020-05-07 |
| 1932720836 | Vera Whole Health Wa, PC | Clinic/Center | 6620 Main St, 12th Flr, Ste 1225, Houston, TX 77030 | 2020-05-01 |
| 1548881808 | Mobitz Heart and Rhythm Center Pllc | Internal Medicine | Scurlock Tower, 6560 Fannin St., Houston, TX 77030 | 2020-04-28 |
| 1710516513 | Thomas Chi Han Lu | Student in an Organized Health Care Education/Training Program | 6431 Fannin Street, Msb 3.151, Houston, TX 77030 | 2020-04-03 |
| 1063041085 | Kevin Tang | Student in an Organized Health Care Education/Training Program | 7200 Cambridge., Bcm 903, Suite A10.202, Houston, Texas, TX 77030 | 2020-04-02 |
| 1831728898 | Taylor Renbarger | Student in an Organized Health Care Education/Training Program | 6431 Fannin St Suite Jjl 431, Houston, TX 77030 | 2020-04-02 |
| 1972131423 | Sindhu R Rao | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street, 9th Floor, Suite 9a, Houston, TX 77030 | 2020-03-31 |
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| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164757712 | Virginia Cortes Araiza | Pediatrics | 3701 W Alabama St Ste 350, Houston, TX 77027-5264 | 2009-10-14 |
| 1730378456 | Vandana S Raman | Pediatrics | 6621 Fannin St # Cc102005, Suite 1020, Houston, TX 77030-2303 | 2007-10-18 |
| 1114017340 | Parvin Yazdani-kachooei | Pediatrics | Clinical Care Center, 6621 Fannin St 11th Floor, Houston, TX 77030 | 2006-10-16 |
| 1801213046 | Richard Ogden Roberts IIi | Pediatrics | 6701 Fannin St, Houston, TX 77030-2608 | 2014-03-26 |
| 1609217819 | Rocio A Harbison Md Pa | Pediatrics | 7400 Fannin St, Suite 855, Houston, TX 77054-1920 | 2013-07-16 |
| 1033554191 | Virginia Cortes Araiza Md Pllc | Pediatrics | 3701 W Alabama St, Suite 350, Houston, TX 77027-5290 | 2013-05-02 |
| 1376987479 | Grace Kwang Kim | Pediatrics | 6701 Fannin St Ste 1020, Houston, TX 77030-2611 | 2013-04-19 |
| 1487915609 | Selorm Aseye Adzaku Dei-tutu | Pediatrics | 6701 Fannin Street, Pediatric Endocrinology, Houston, TX 77030 | 2012-06-05 |
| 1982972154 | Serife Uysal | Pediatrics | 6701 Fannin St, Houston, TX 77030-2608 | 2011-12-02 |
| 1952600215 | Sara K Bartz | Pediatrics | 6621 Fannin St, Ste 1020, Houston, TX 77030-2358 | 2011-03-24 |
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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.