MRS. KELLY NICOLE SMITH (NPI# 1780673772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780673772 |
| Entity Type | Individual |
| Full Name | MRS. KELLY NICOLE SMITH |
| Credential | PA-C |
| Practice Address |
1307 Lafayette Ave Moundsville WV 26041-2316 |
| Practice Telephone | 3048452500 |
| Practice Fax Number | 3048452624 |
| Mailing Telephone | 3048452500 |
| Mailing Fax Number | 3048452624 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2018-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
222 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566371 | Kelly Rae Smith | Nurse Practitioner | 13402 Creekview Rd, Prospect, KY 40059-9028 | 2020-10-22 |
| 1447877899 | Kelly Smith | Dental Hygienist | 7700 Sw Garden Home Rd Apt 24, Portland, OR 97223-7496 | 2020-07-01 |
| 1346720893 | Kelly Smith | Licensed Vocational Nurse | 512 S Kearny, Clarendon, TX 79226 | 2018-08-15 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1013437870 | Kelly Dennis Smith | Public Health or Welfare | 211 Oakmont Dr, New Orleans, LA 70128-3624 | 2017-06-22 |
| 1164955498 | Kelly Ghislaine Smith | Student in an Organized Health Care Education/Training Program | 171 Old Chester Rd, Essex Fells, NJ 07021-1624 | 2017-04-04 |
| 1588026975 | Kelly Therese Smith | Specialist/Technologist | 344 S Maple Ave #2a, Oak Park, IL 60302 | 2016-03-24 |
| 1790168326 | Kelly Smith | Counselor | 545 Sw 26th St, Oklahoma City, OK 73109-6740 | 2015-07-01 |
| 1518353341 | Kelly Smith | Nurse Practitioner | 2232 Wilborn Ave Ste D, South Boston, VA 24592-1662 | 2015-04-08 |
| 1265830491 | Kelly Sue Smith | Speech-Language Pathologist | 210 Starpine Pl Unit A, Prescott, AZ 86303-7017 | 2014-12-22 |
| Street Address |
1307 LAFAYETTE AVE |
| City | MOUNDSVILLE |
| State | WV |
| Zip Code | 26041-2316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275924441 | Wood Health Care Clinic Lab | Clinical Medical Laboratory | 1307 Lafayette Ave, Moundsville, WV 26041-2316 | 2015-02-10 |
| 1205080488 | Jason Snider | Physician Assistant | 1307 Lafayette Ave, Moundsville, WV 26041-2316 | 2008-11-13 |
| 1134294036 | Robert T. Potts | Physician Assistant | 1307 Lafayette Ave, Moundsville, WV 26041-2316 | 2006-11-24 |
| 1396709861 | Duane A. Bartsch | Physician Assistant | 1307 Lafayette Ave, Moundsville, WV 26041-2316 | 2006-04-13 |
| 1477516722 | Ralph E Wood | Family Medicine | 1307 Lafayette Ave, Moundsville, WV 26041-2316 | 2006-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093272577 | Tonya Sue Roush | Technician | 2056 Center Street, Moundsville, WV 26041 | 2019-02-21 |
| 1720568264 | Christina Robinson | Registered Nurse | Washington Lands Elementary, 116 School Rd., Moundsville, WV 26041 | 2018-08-15 |
| 1962935296 | Tracy A. Zang | Dentist | 112 Correctional Dr., Northern Regional Correctional Facility, Moundsville, WV 26041 | 2017-04-04 |
| 1154861052 | Andrea Garrison | Specialist/Technologist | 633 Blairs Ridge Rd, Moundsville, WV 26041 | 2017-02-27 |
| 1932643418 | First Settlement Physical Therapy | Physical Therapist | 1216 Lafayette Ave, Moundsville, WV 26041 | 2016-12-19 |
| 1245772177 | The Village Network | Community/Behavioral Health | 52 Fourteenth Street, Wheeling, WV 26041 | 2016-11-09 |
| 1144516683 | Sarah D Dean | Counselor | 324 7th and Lafayette Street, Moundsville, WV 26041 | 2011-06-23 |
| 1114101540 | Becky Poling | Speech-Language Pathologist | 2700 Eastern Fourth Street, Moundsville, WV 26041 | 2007-12-20 |
| 1871775213 | Cathy Jones | Registered Nurse | 2700 Fourth Street, Marshall County Board of Education, Moundsville, WV 26041 | 2007-11-28 |
| 1326262536 | Marshall County Health Department | Public Health or Welfare | 6th Street & Court Avenue, Moundsville, WV 26041 | 2007-04-12 |
| Find all providers in zip 26041 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386270908 | Bonnie Lynn Blackburn | Physician Assistant | 10 Amalia Dr Ste C5, Buckhannon, WV 26201-2270 | 2020-03-15 |
| 1922638824 | Sara B Johnson | Physician Assistant | 1000 Mon Health Medical Park Dr Ste 1100, Morgantown, WV 26505-1143 | 2020-01-19 |
| 1659835072 | Kristen Nicole Williams | Physician Assistant | 26 Portsmouth Ct N, Falling Waters, WV 25419-1430 | 2019-01-30 |
| 1629588876 | Robert Theodore Hartman | Physician Assistant | 620 National Rd Ste 300, Wheeling, WV 26003-6560 | 2017-10-02 |
| 1366967986 | Terri Leanne Belcher | Physician Assistant | 395 Emily Dr, Clarksburg, WV 26301-5505 | 2017-08-04 |
| 1760937056 | Ryan Aston | Physician Assistant | 58 16th St Fl 4, Wheeling, WV 26003-3660 | 2016-08-17 |
| 1821470113 | Lesley E. Weiss | Physician Assistant | 3200 Maccorkle Seave, Charleston, WV 25304-1227 | 2015-06-23 |
| 1891197323 | Rachelle Lyle Stewart | Physician Assistant | 1500 Terrace St Ste 105, Hinton, WV 25951-9768 | 2014-09-16 |
| 1285043224 | Sarah Gutman Brammer | Physician Assistant | 30 Medical Park Ste 211, Wheeling, WV 26003-6391 | 2014-08-04 |
| 1841603529 | Timothy Douglas | Physician Assistant | 4202 Mccorkle Ave Sw Ste 200, South Charleston, WV 25309-1513 | 2014-06-10 |
| Find all providers with the same taxonomy | ||||
| City | MOUNDSVILLE |
| Zip Code | 26041 |
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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.