DR. KELLY NEAVES MCDONOUGH (NPI# 1831195528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831195528 |
| Entity Type | Individual |
| Full Name | DR. KELLY NEAVES MCDONOUGH |
| Credential | M.D. |
| Practice Address |
2601 Kelley Pointe Pkwy Ste 101 Edmond OK 73013-2996 |
| Practice Telephone | 4058442601 |
| Practice Fax Number | 4058442610 |
| Mailing Telephone | 4058442601 |
| Mailing Fax Number | 4058442610 |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2011-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
19508 | OK | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255577854 | Kelly Anne Mcdonough | Specialist | 8460 Parsons Blvd, Jamaica, NY 11432-2544 | 2009-01-02 |
| 1336365279 | Kelly R Mcdonough | Physical Therapist | 11293 N M 37 Ste B, Buckley, MI 49620-9593 | 2007-04-18 |
| 1326261900 | Kelly Franklyn Mcdonough | Dentist | 19 Monarch Bay Plz, Dana Point, CA 92629-3424 | 2007-04-11 |
| 1881080232 | Kelly Lelia Mcdonough | Nurse Practitioner | 800 E 28th St, Minneapolis, MN 55407-3723 | 2015-04-13 |
| 1578859872 | Kelly Mcdonough | Student in an Organized Health Care Education/Training Program | 101 Dudley St, Providence, RI 02905-2401 | 2011-06-24 |
| Street Address |
2601 KELLEY POINTE PKWY STE 101 |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-2996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346550787 | Melissa Craft | Registered Nurse | 2601 Kelley Pointe Pkwy, Edmond, OK 73013-2995 | 2010-10-19 |
| 1609078559 | Tina D Dickerson | Radiology | 2601 Kelley Pointe Pkwy, Ste. 101, Edmond, OK 73013-2995 | 2007-06-04 |
| 1225243207 | Lori Ann Fredrick | Radiology | 2601 Kelley Pointe Pkwy, Ste. 101, Edmond, OK 73013-2995 | 2007-05-11 |
| 1952307647 | Ashley Anne Magness | Radiology | 2601 Kelley Pointe Pkwy, Ste 101, Edmond, OK 73013-2996 | 2005-06-27 |
| 1992701684 | Debra Mitchell | Radiology | 2601 Kelley Pointe Pkwy, Ste 101, Edmond, OK 73013-2996 | 2005-06-27 |
| 1619973336 | Carol Virginia Sheldon | Radiology | 2601 Kelley Pointe Pkwy, Ste 101, Edmond, OK 73013-2996 | 2005-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760829220 | Derrick Durell Wagoner | Radiology | 1800 Renaissance Blvd Ste 110, Edmond, OK 73013 | 2013-05-23 |
| 1952662363 | Julia Dry Knarreborg | Radiology | 1817 Rocky Mountain Way, Edmond, OK 73003-4640 | 2012-06-01 |
| 1346508041 | Telerad of Ok Account Management, LLC | Radiology | 4608 Briar Meade Rd, Edmond, OK 73025-9222 | 2012-05-01 |
| 1437390499 | Andrew Stone | Radiology | 2709 Nw 187th Ter, Edmond, OK 73012-7623 | 2009-03-20 |
| 1316198088 | Rodney Alen Kernes | Radiology | 432 Pacific Crest Trl, Edmond, OK 73003-2061 | 2008-09-30 |
| 1013045756 | Roger Barrett Collins | Radiology | 17104 Hawks Ridge Ln, Edmond, OK 73003-8400 | 2007-03-02 |
| 1588699136 | Kamlesh H Naik | Radiology | 3414 S Broadway, Edmond, OK 73013-4103 | 2006-07-12 |
| 1184692576 | Robin E Acker | Radiology | 1849 Fairmont Ln, Edmond, OK 73013-2938 | 2006-03-10 |
| 1063480333 | Laurie J Hast | Radiology | 1208 Blue Wister Cv, Edmond, OK 73013-1367 | 2006-03-10 |
| 1962485524 | Foundation Radiology Group PC | Radiology | 3509 French Park Dr Ste E, Edmond, OK 73034-7291 | 2005-11-28 |
| Find all providers in EDMOND | ||||
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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.