KELLY LYNN ANDERSON (NPI# 1831639293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831639293 |
| Entity Type | Individual |
| Full Name | KELLY LYNN ANDERSON |
| Credential | ATC |
| Practice Address |
3855 Pleasant Hill Rd Suite 130 Duluth GA 30096-1407 |
| Practice Telephone | 6783127880 |
| Practice Fax Number | 6783127890 |
| Mailing Telephone | 6783127880 |
| Mailing Fax Number | 6783127890 |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
060802416 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083234710 | Kelly Mankin Anderson | Audiologist | 135 Nw 17th St, Bend, OR 97703-2420 | 2020-04-22 |
| 1184255408 | Kelly Marie Anderson | Registered Nurse | 10600 W 500 N, Deputy, IN 47230-8999 | 2020-01-27 |
| 1982188470 | Kelly Brooke Anderson | Clinic/Center | 2215 Veterans Blvd, Metairie, LA 70002 | 2018-09-20 |
| 1457858300 | Kelly R Anderson | Nurse Practitioner | 10120 W Broad St Ste F, Glen Allen, VA 23060-6709 | 2018-04-08 |
| 1538578430 | Kelly Elizabeth Anderson | Student in an Organized Health Care Education/Training Program | 1512 Spreckels St, Honolulu, HI 96822-4658 | 2014-08-05 |
| 1528394681 | Kelly Elizabeth Anderson | Physical Therapist | 1742 Commonwealth Ave, Apt 2, Brighton, MA 02135 | 2009-10-26 |
| 1568694115 | Kelly L Anderson | Physical Therapist | 1325 Spring St., Greenwood, SC 29649 | 2009-08-17 |
| 1255586475 | Kelly Marie Anderson | Nurse's Aide | 1720 17th Ct, Jupiter, FL 33477-9089 | 2008-12-02 |
| 1114056637 | Kelly L Anderson | Social Worker | 655 E. Main St, Children's Hospital Guidance Center, Columbus, OH 43205 | 2007-03-02 |
| 1144828658 | Kelly Herbert Anderson | Social Worker | 220 N Ballston Ave, Scotia, NY 12302-2533 | 2020-10-16 |
| Street Address |
3855 PLEASANT HILL RD SUITE 130 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013915586 | Michael John Pickford | Otolaryngology | 3855 Pleasant Hill Rd, Suite 280, Duluth, GA 30096-1407 | 2005-07-08 |
| 1831699958 | Regenerative Sports Medicine Inc | Orthopaedic Surgery | 3855 Pleasant Hill Rd, Duluth, GA 30096-1407 | 2018-02-15 |
| 1548709314 | Georgia Plastic Surgery Specialist | General Acute Care Hospital | 3855 Pleasant Hill Rd, Suite #300, Duluth, GA 30096-1407 | 2017-02-14 |
| 1215311402 | Cha Ob/gyn | Obstetrics & Gynecology | 3855 Pleasant Hill Rd, Suite 270, Duluth, GA 30096-1407 | 2015-07-17 |
| 1659794691 | Gwinnett Ear Nose & Throat, LLC | Otolaryngology | 3855 Pleasant Hill Rd, Suite 280, Duluth, GA 30096-1407 | 2014-01-28 |
| 1386083814 | Nicholas Matthew Rossi | Physician Assistant | 3855 Pleasant Hill Rd, Suite 470, Duluth, GA 30096-1407 | 2013-06-18 |
| 1811237571 | Ashley Lucia Feeney | Specialist/Technologist | 3855 Pleasant Hill Rd, Hudgens Building Suite 470, Duluth, GA 30096-1407 | 2013-02-18 |
| 1730438920 | David Robert Braatz | Audiologist | 3855 Pleasant Hill Rd, Suite 280, Duluth, GA 30096-1407 | 2012-09-03 |
| 1528334190 | Southern Plastic Surgery, P.C. | Specialist | 3855 Pleasant Hill Rd, Suite 370, Duluth, GA 30096-1407 | 2012-03-28 |
| 1568766822 | David B Pharis Md PC | Dermatology | 3855 Pleasant Hill Rd, Suite 200, Duluth, GA 30096-1407 | 2010-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851906697 | Tadd William Berg | Specialist/Technologist | 2415 W 9th St, Duluth, MN 55806-1150 | 2020-09-09 |
| 1952916793 | Megan Marie Hautajarvi | Specialist/Technologist | 2536 Peace Dr, Duluth, MN 55811-2971 | 2020-09-09 |
| 1699380519 | Kourtney Jean Palmi | Specialist/Technologist | 4922 Howard Gnesen Rd, Duluth, MN 55803-2710 | 2020-09-09 |
| 1144787375 | Andrew Eric Norris | Specialist/Technologist | 2316 W 9th St Apt 1, Duluth, MN 55806-1229 | 2019-02-24 |
| 1417445776 | Jacqueline Marie Schultz | Specialist/Technologist | 2231 W 3rd St Apt 5, Duluth, MN 55806-1946 | 2018-04-23 |
| 1003315425 | Nicole Breuer | Specialist/Technologist | 1200 Kenwood Ave # 1665, Duluth, MN 55811-4199 | 2018-02-12 |
| 1003329640 | Michelle Whitt | Specialist/Technologist | 607 Kenwood Ave Apt 108, Duluth, MN 55811-2181 | 2017-11-06 |
| 1083145577 | William John Jensen | Specialist/Technologist | 3820 London Rd Apt 204, Duluth, MN 55804-2235 | 2017-03-25 |
| 1942743950 | Thomas Anthony Olson | Specialist/Technologist | 1049 Ordean Court, 170 Sports & Health Center, Duluth, MN 55812 | 2016-11-22 |
| 1821544784 | Devin Zenner | Specialist/Technologist | 1012 East Second St Level 5, Duluth, MN 55805-2200 | 2016-08-31 |
| Find all providers in DULUTH | ||||
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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.