KELLY C BANONIS (NPI# 1790395531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790395531 |
| Entity Type | Individual |
| Full Name | KELLY C BANONIS |
| Other Name | KELLY C STUART |
| Credential | NP |
| Practice Address |
3322 N Brighton Mesa AZ 85207-0997 |
| Practice Telephone | 8152914460 |
| Mailing Telephone | 8152914460 |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
245540 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3322 N BRIGHTON |
| City | MESA |
| State | AZ |
| Zip Code | 85207-0997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790241743 | Sharin Lane | Physical Therapist | Spooner North Mesa, PC, 6824 E Brown Rd # 102, Mesa, AZ 85207 | 2019-02-14 |
| 1154898435 | Phoenix Physician Group, LLC | Emergency Medicine | 3430 N. Mountain Ridge, Unit 14, Mesa, AZ 85207 | 2018-10-25 |
| 1467970939 | Kerry Mae Kenley | Specialist/Technologist | 7556 E. Laurel St, Mesa, AZ 85207 | 2017-09-05 |
| 1053709287 | Barbara Bowen | Speech-Language Pathologist | 8433 E. Leland St., Mesa, AZ 85207 | 2014-12-22 |
| 1043561046 | Joseph Allen Kempton | Physical Therapist | 844 N. Ellsworth Rd, Mesa, AZ 85207 | 2012-10-01 |
| 1629327556 | Odyssey Services Corp. | Community/Behavioral Health | 8947 East Quill Street, Mesa, AZ 85207 | 2012-09-06 |
| 1962729160 | Chao Li | Dermatology | 6832 E Brown Rd, Mesa, AZ 85207 | 2010-04-27 |
| 1366670929 | Trevor Lee Caffall | Dentist | 6812 E. Brown Rd., Ste 102, Mesa, AZ 85207 | 2009-06-22 |
| 1396928073 | Dht Hand Therapy Limited Partnership | Occupational Therapist | 7165 E University Dr Ste 143, Mesa, AZ 85207 | 2007-12-17 |
| 1184794075 | Karen L Thomas Pllc | Nurse Practitioner | 3902 N. Stone Gully Cricle, Mesa, AZ 85207 | 2006-11-08 |
| Find all providers in zip 85207 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926410 | Matthew Derrick Miller | Nurse Practitioner | 9354 E Thatcher Cir, Mesa, AZ 85212-8539 | 2020-09-12 |
| 1750995858 | Hayley Madler | Nurse Practitioner | 1061 N Omaha Cir, Mesa, AZ 85205-5023 | 2020-09-04 |
| 1043823800 | Nancy Lynn Mitchell | Nurse Practitioner | 1535 N 26th St, Mesa, AZ 85213-4151 | 2020-08-30 |
| 1003429218 | Krista Ann Clevenger | Nurse Practitioner | 3155 E Southern Ave Ste 203, Mesa, AZ 85204-5521 | 2020-08-26 |
| 1093326290 | Joshua Jackson | Nurse Practitioner | 5432 E Southern Ave Ste 101b, Mesa, AZ 85206-2772 | 2020-08-11 |
| 1689284911 | Katie Keil | Nurse Practitioner | 1061 N Dobson Rd Ste 107, Mesa, AZ 85201-7576 | 2020-08-02 |
| 1831711670 | Saraswati Hamal | Nurse Practitioner | 4850 S Curie Way, Mesa, AZ 85212-9582 | 2020-05-14 |
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1659992436 | Elizabeth Erb | Nurse Practitioner | 1361 S Alma School Rd, Mesa, AZ 85210-2085 | 2020-05-02 |
| 1437770518 | Lutz Get Healthy LLC | Nurse Practitioner | 2550 S Ellsworth Rd Unit 297, Mesa, AZ 85209-2207 | 2020-04-30 |
| Find all providers in MESA | ||||
Please comment or provide details below to improve the information on KELLY C BANONIS.
| 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.