MR. KELLY BRYAN GINES (NPI# 1770078842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770078842 |
| Entity Type | Individual |
| Full Name | MR. KELLY BRYAN GINES |
| Credential | FNP-C |
| Practice Address |
6321 S Redwood Rd Ste 201 Taylorsville UT 84123-6972 |
| Mailing Address |
2044 N 3700 W Plain City UT 84404-9485 |
| Practice Telephone | 8019240848 |
| Mailing Telephone | 8014580889 |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2020-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 8334395 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
8334395-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6321 S REDWOOD RD STE 201 |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84123-6972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186837 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5792 South Redwood Road, Taylorsville, UT 84123 | 2020-08-27 |
| 1164040614 | Mark E Hutchinson | Counselor | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1396259321 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4082 South Redwood Road, West Valley Road, UT 84123 | 2017-11-29 |
| 1083131890 | Kelli Mcstotts | Counselor | 5689 S. Redwood Road, Taylorsville, UT 84123 | 2017-08-23 |
| 1740706571 | Laura B Ellsworth | Case Manager/Care Coordinator | 5667 So. Redwood Road, 6b, Salt Lake City, UT 84123 | 2017-08-14 |
| 1790214120 | Integrated Autism Therapies | Behavioral Analyst | 5984 S. Susquehanna, Murray, UT 84123 | 2017-06-08 |
| 1083163885 | Michael John Flint | Counselor | 5861 South Redwood Road, #24, Taylorsville, UT 84123 | 2016-09-22 |
| 1548716236 | Andres Ramos | Licensed Psychiatric Technician | 697 West 4170 South, Murray, UT 84123 | 2016-09-01 |
| 1467807040 | Sheryl R Schindler | Counselor | 5770 South 1550 West, Bldg G, Primary Children's Counseling Center, Taylorsville, UT 84123 | 2016-05-02 |
| 1730562141 | Megan Merica Snarr | Dentist | 597 West 5300 South, Murray, UT 84123 | 2015-07-02 |
| Find all providers in zip 84123 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245890383 | Arlene R Holland | Nurse Practitioner | 3042 W Ivory Way, Taylorsville, UT 84129-6800 | 2019-06-20 |
| 1821562646 | Emily Rose Pierce | Nurse Practitioner | 1127 Chatman Ln, Taylorsville, KY 40071-9783 | 2019-01-15 |
| 1023467313 | Carrie Chestnut Herman | Nurse Practitioner | 50 Macedonia Church Rd Ste A, Taylorsville, NC 28681-8414 | 2016-06-07 |
| 1831334077 | Michelle A. Neeshan | Nurse Practitioner | 4600 S Redwood Rd # Stc048, Taylorsville, UT 84123-3145 | 2008-12-02 |
| 1154375020 | Ethel Darline Luster Caldwell | Nurse Practitioner | 870 Taylorsville Road, Taylorsville, KY 40071 | 2006-05-22 |
| 1104815141 | Sharon S Jamison | Nurse Practitioner | 501 Taylorsville Rd, Taylorsville, KY 40071-6766 | 2005-10-20 |
| 1932718590 | Darren L Sorensen | Nurse Practitioner | 6575 S Redwood Rd, Taylorsville, UT 84123-5688 | 2020-07-29 |
| 1285269241 | Lucretia Davis | Nurse Practitioner | 625 Taylorsville Rd, Taylorsville, KY 40071-7798 | 2020-03-10 |
| 1447891676 | Shamis Tate | Nurse Practitioner | 6575 S Redwood Rd Ste 350, Taylorsville, UT 84123-5693 | 2019-09-29 |
| 1861046773 | Brooke Nicole-hayes Massenburg | Nurse Practitioner | 31 E Main Ave, Taylorsville, NC 28681-2540 | 2019-07-29 |
| Find all providers in TAYLORSVILLE | ||||
| City | TAYLORSVILLE |
| Zip Code | 84123 |
Please comment or provide details below to improve the information on MR. KELLY BRYAN GINES.
| 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.