RUSSELL S KELLY (NPI# 1790787729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790787729 |
| Entity Type | Individual |
| Full Name | RUSSELL S KELLY |
| Credential | MD |
| Practice Address |
91-2139 Fort Weaver Rd Suite 300 Ewa Beach HI 96706-3607 |
| Practice Telephone | 8086780700 |
| Practice Fax Number | 8086780776 |
| Mailing Telephone | 8086780700 |
| Mailing Fax Number | 8086780776 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2008-02-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 11807 | HI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | 539207 | 05 | |
| HI | 0000241885 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841219789 | Russell F Kelly | Internal Medicine | 6701 Airport Blvd Ste C138, Mobile, AL 36608-3784 | 2006-07-19 |
| 1285882977 | Russell A. Kelly | Dentist | 951 N Tustin St, Orange, CA 92867-5902 | 2008-09-05 |
| 1346430428 | Russell James Kelly | Specialist/Technologist | 550 S College Ave, Newark, DE 19713-1302 | 2007-07-26 |
| 1043316532 | Russell Aaron Kelly | Physician Assistant | 103 Myron St, Suite A, West Springfield, MA 01089-1598 | 2006-09-15 |
| Street Address |
91-2139 FORT WEAVER RD SUITE 300 |
| City | EWA BEACH |
| State | HI |
| Zip Code | 96706-3607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255876660 | West Oahu Medical Genetics, LLC | Clinic/Center | 91-2139 Fort Weaver Rd, Ste 100, Ewa Beach, HI 96706-3607 | 2016-12-21 |
| 1972942118 | West Oahu Primary Care LLC | Clinic/Center | 91-2139 Fort Weaver Rd, Suite 213, Ewa Beach, HI 96706-3607 | 2013-06-20 |
| 1073881009 | Richard S Oh Md LLC | Clinic/Center | 91-2139 Fort Weaver Rd, Suite 309, Ewa Beach, HI 96706-3607 | 2011-12-05 |
| 1720378664 | Yongsok Do, D.m.d., L.l.c | Dentist | 91-2139 Fort Weaver Rd, Suite 301, Ewa Beach, HI 96706-3607 | 2011-04-12 |
| 1720393937 | Charles A. Wilson D.o., LLC | Family Medicine | 91-2139 Fort Weaver Rd, Suite 213, Ewa Beach, HI 96706-3607 | 2010-08-11 |
| 1659603884 | James H.e. Ireland Md, LLC | Internal Medicine | 91-2139 Fort Weaver Rd, #100, Ewa Beach, HI 96706-3607 | 2010-02-15 |
| 1922249861 | Kristen R N Vail | Physical Therapist | 91-2139 Fort Weaver Rd, Ste 210, Ewa Beach, HI 96706-3609 | 2009-03-23 |
| 1578722245 | Howard F. Neudorf, M.d. | Clinic/Center | 91-2139 Fort Weaver Rd, Suite 213, Ewa Beach, HI 96706-3607 | 2008-06-06 |
| 1003006198 | Laura C Miller | Psychiatry & Neurology | 91-2139 Fort Weaver Rd, Pob Suite 101, Ewa Beach, HI 96706-3607 | 2007-07-26 |
| 1467580712 | Ewa Beach Physical Therapy LLC | Clinic/Center | 91-2139 Fort Weaver Rd, Ste 210, Ewa Beach, HI 96706-3609 | 2007-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625516 | Alison Tolentino | Technician | 91-3633 Kauluakoko Street, Ewa Beach, HI 96706 | 2020-06-29 |
| 1851915722 | Sheree Cole Wilson | Social Worker | 6851 B 112th Street, Ewa Beach, HI 96706 | 2020-06-05 |
| 1811547144 | Madelyn Valenzuela | Technician | 91-1007 Napoona St., Ewa Beach, HI 96706 | 2019-09-18 |
| 1932761673 | Kina'ole Case Management Agency LLC | Case Management | 91-1163 Olowa Street Ewa Beach Hi 96706, Ewa Beach, HI 96706 | 2019-07-02 |
| 1952875049 | Vegafit Elite Fitness and Training | Family Medicine | 91-2131 Kaioli St, #3403, Ewa Beach, HI 96706 | 2019-01-11 |
| 1912470345 | Kristen Eiko Kane | Speech-Language Pathologist | 91-1561 Keaunui Dr, Ewa Beach, HI 96706 | 2019-01-08 |
| 1871069849 | Desiree Tricarico | Nurse Practitioner | 91-6390 Kapolei Pkwy, Suite 200, Ewa Beach, HI 96706 | 2018-10-17 |
| 1598251894 | Ewa Beach Dentists LLC | Clinic/Center | 105 Fort Weaver Road, Ste 105, Ewa Beach, HI 96706 | 2018-07-10 |
| 1427586833 | Alison Mcdonald Cameron | Marriage & Family Therapist | 6186a Ibis Ave, Ewa Beach, HI 96706 | 2017-05-30 |
| 1629528567 | Cindy Ann Holden | Contractor | 91755 B Fort Weaver Road, Ewa Beach, HI 96706 | 2016-10-04 |
| Find all providers in zip 96706 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619456035 | Elmer F. Baysa Md, Inc | Internal Medicine | 91-775 Papipi Rd Ste A, Ewa Beach, HI 96706-2466 | 2018-08-07 |
| 1184754970 | Laverne Arabella Kia | Internal Medicine | 912139 Fort Weaver Road, Suite 209, Ewa Beach, HI 96706 | 2007-03-07 |
| 1699829127 | Elmer F. Baysa | Internal Medicine | 91-775 Papipi Rd, #a, Ewa Beach, HI 96706-2466 | 2007-01-22 |
| 1184700353 | Aurora C Mariani | Internal Medicine | 91-2139 Fort Weaver Rd. #307, Ewa Beach, HI 96706-3610 | 2006-10-31 |
| 1639103070 | Glenda Malana | Internal Medicine | 91-2139 Fort Weaver Rd Ste 302, Ewa Beach, HI 96706-3609 | 2006-07-10 |
| 1497790281 | Myrna S Uytingco | Internal Medicine | 91-2135 Fort Weaver Rd Ste 150, Ewa Beach, HI 96706-1929 | 2006-06-17 |
| 1346777059 | Roui Lorenzo Canicula De Castro | Internal Medicine | 91-6390 Kapolei Pkwy Ste 200, Ewa Beach, HI 96706 | 2017-05-12 |
| 1366890469 | Deep Patel | Internal Medicine | 91-2141 Fort Weaver Rd, Ewa Beach, HI 96706-1993 | 2016-05-31 |
| 1780006106 | Rainbow Shower Inpatient Services LLC | Internal Medicine | 91-2141 Fort Weaver Rd, Ewa Beach, HI 96706-1993 | 2014-01-21 |
| 1801189535 | Salvatore Abbruzzese LLC | Internal Medicine | 91-2141 Fort Weaver Rd, Ewa Beach, HI 96706-1993 | 2011-05-27 |
| Find all providers in EWA BEACH | ||||
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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.