MICHAEL C KELLY (NPI# 1760425201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760425201 |
| Entity Type | Individual |
| Full Name | MICHAEL C KELLY |
| Credential | NP |
| Practice Address |
413 Lilly Rd Ne Olympia WA 98506-5133 |
| Mailing Address |
Po Box 5007 Lacey WA 98509-5007 |
| Practice Telephone | 3604919480 |
| Mailing Telephone | 8005990166 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2007-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN00124941 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA L & I | 199382 | 01 | |
| REGENCE BS | 6059KE | 01 | |
| WA | 9635574 | 05 | |
| WA CRIME VICTIMS | 8906877 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389874 | Michael Kelly | Physical Therapist | 1025 Service Pl Ste 200, Vista, CA 92084-7271 | 2020-09-03 |
| 1871949115 | Michael John Kelly | Speech-Language Pathologist | 3484 Fair Oaks Ave, Bowling Green, KY 42104-5529 | 2016-05-05 |
| 1003206004 | Michael Sean Kelly | Nurse Practitioner | 17601 17th St Ste 120, Tustin, CA 92780-1946 | 2015-01-28 |
| 1295135515 | Michael Kelly | Technician, Other | 2215 E 36 1/2 St, Minneapolis, MN 55407-3018 | 2014-08-25 |
| 1225310675 | Michael Thomas Kelly | Pathology | 4156 H Street Rd, Blaine, WA 98230-9228 | 2011-09-12 |
| 1205085073 | Michael H Kelly | Massage Therapist | 76 Bosse Ln, West Seneca, NY 14224-1624 | 2008-09-16 |
| 1275780041 | Michael Foster Kelly | Acupuncturist | 8 Wells Ave, Yonkers, NY 10701-2710 | 2008-08-25 |
| 1346458031 | Michael Francis Kelly | Registered Nurse | 79 Trausneck Pl, Yonkers, NY 10703-1907 | 2007-05-18 |
| 1104045707 | Michael Walter Kelly | Pharmacist | College of Pharmacy, 110 Pharmacy Building, Iowa City, IA 52242-1112 | 2007-04-24 |
| 1710105358 | Michael Kelly | Physical Therapist | 1600 E. Jefferson St., Seattle, WA 98122 | 2007-04-20 |
| Street Address |
413 LILLY RD NE |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157674 | Michael J Menen | Internal Medicine | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2005-07-12 |
| 1558962209 | Anieska Timms | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-11-07 |
| 1134737653 | Ngoc-van Thi Tran | Speech-Language Pathologist | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-07-21 |
| 1780292714 | Paola Von Oelffen | Student in an Organized Health Care Education/Training Program | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-07-15 |
| 1013542885 | Raffy Jatamosa | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-03-11 |
| 1811522766 | Kaman Lindgren | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-03-10 |
| 1497389886 | Phuong Le | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-02-25 |
| 1679107239 | Tamara Eklund | Registered Nurse | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2020-02-23 |
| 1598307878 | Alisa Singratanakul | Pharmacist | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2019-10-08 |
| 1528615192 | Anh Phuong Ho | Pharmacist | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2019-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700366572 | Robert James Wright | Nurse Practitioner | 622 Meadowwood Dr Sw, Olympia, WA 98502-2677 | 2018-08-20 |
| 1881108553 | Percy Lee Lynchard IIi | Nurse Practitioner | 4001 Harrison Ave Nw Ste 101, Olympia, WA 98502-5084 | 2017-11-16 |
| 1598170904 | Altegra Health Connections, LLC | Nurse Practitioner | 505 Union Avenue Se, Suite 120, Olympia, WA 98501-1474 | 2014-06-24 |
| 1386945905 | Adrienne E Wasserman | Nurse Practitioner | 420 Mcphee Rd Sw Ste A, Olympia, WA 98502-4070 | 2010-11-12 |
| 1396054946 | Maureen Coyle Considine | Nurse Practitioner | 2617 Cain Road South East, Olympia, WA 98501 | 2010-09-30 |
| 1518281930 | Marjorie Elizabeth Miller | Nurse Practitioner | 3525 Ensign Rd Ne Ste N, Olympia, WA 98506-5065 | 2010-03-15 |
| 1366627663 | Melissa A Sarhan | Nurse Practitioner | 8338 49th Loop Se, Olympia, WA 98513-4716 | 2008-01-04 |
| 1356479448 | Maribeth E Flood | Nurse Practitioner | 2217 Capital Way South, Olympia, WA 98501 | 2007-03-01 |
| 1205980828 | Linda Sue Kellams | Nurse Practitioner | 2114 Caton Way Sw # 201, Olympia, WA 98502-1105 | 2007-01-22 |
| 1154433597 | Boney K. Mcgone | Nurse Practitioner | 155 Lilly Rd Ne Ste A, Olympia, WA 98506-5028 | 2006-08-31 |
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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.