KIMBERLY ANN KELLEY (NPI# 1841519030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841519030 |
| Entity Type | Individual |
| Full Name | KIMBERLY ANN KELLEY |
| Credential | R.D. |
| Practice Address |
221 Ne Glen Oak Ave Peoria IL 61636-0002 |
| Practice Telephone | 3096724954 |
| Practice Fax Number | 3096724953 |
| Mailing Telephone | 3096724954 |
| Mailing Fax Number | 3096724953 |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 164004335 | IL | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861895112 | Kimberly Kelley | Pharmacist | 2444 W Las Palmaritas Dr, Phoenix, AZ 85021-4860 | 2014-10-01 |
| 1568686111 | Kimberly Ann Kelley | Pharmacist | 71 Lowell Rd, Concord, MA 01742-1709 | 2007-04-13 |
| 1720169170 | Kimberly A Kelley | Dentist | 1103 Hwy 3351 N, Kendalia, TX 78027 | 2006-10-18 |
| 1346894755 | Kimberly Anne Kelley | Registered Nurse | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2019-07-25 |
| 1427572312 | Kimberly Jane Kelley | Counselor | 16314 Cornuta Ave, Bellflower, CA 90706-4814 | 2017-08-01 |
| 1578961694 | Kimberly Kelley | Nurse Practitioner | 2470 Daniels Bridge Rd, Building 200, Suite 251, Athens, GA 30606-6187 | 2014-12-06 |
| 1326447897 | Kimberly Kelley | Social Worker | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2014-08-20 |
| 1578804258 | Kimberly B Kelley | Physical Therapist | 5 First Village Dr, Pinehurst, NC 28374-8724 | 2013-03-06 |
| 1316232143 | Kimberly Theresa Kelley | Counselor | 36 Cordage Park Cir, Plymouth, MA 02360-7331 | 2011-06-09 |
| 1922392117 | Kimberly Kelley | Pharmacist | 7150 Us 19 N, T-2064, Pinellas Park, FL 33781-4602 | 2011-06-05 |
| Street Address |
221 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61636-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851384135 | John Alan Howerton | Pharmacist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2005-08-23 |
| 1437750130 | Vanezza Buendia | Physical Therapist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-11-08 |
| 1306443056 | Austyn Powers | Nurse Practitioner | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-10-06 |
| 1396357091 | Christopher Legan | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-08-24 |
| 1417575853 | Joseph Babione | Psychologist | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-07-13 |
| 1811512411 | Methodist | Counselor | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-06-10 |
| 1760003230 | Alexandra Bryan | Dietitian, Registered | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-05-06 |
| 1467080523 | Dustin Dariusz Pilat | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-5027 | 2020-04-01 |
| 1295363505 | Abigail Brea Sebald | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
| 1790313054 | Elizabeth Alexandra Edwards | Student in an Organized Health Care Education/Training Program | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2020-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
| 1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
| 1497141758 | Amber Hemminger | Registered Nurse | 200 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2015-04-13 |
| 1326288812 | Bradley Reatherford | Registered Nurse | 221 Northeast Ave, Peoria, IL 61636-0001 | 2009-02-24 |
| 1386784155 | Eric Hawkins | Anesthesiology | 22i Ne Glen Oak Ave, Methodist Medical Center Anesthesiology, Peoria, IL 61636-0001 | 2007-02-08 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1659345007 | Mary C Bruell | Social Worker | Dept of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-14 |
| 1245203280 | University of Illinois | Psychiatry & Neurology | Department of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-09 |
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| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255950366 | Colleen Hamilton | Dietitian, Registered | 1109 W Sleepy Hollow Ct, Peoria, IL 61615-1101 | 2020-04-09 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| 1437536984 | Ashley Thomas | Dietitian, Registered | 1609 W Moss Ave, Peoria, IL 61606-1642 | 2015-05-05 |
| 1205228558 | Ana Cristina Schallhorn | Dietitian, Registered | 4813 N Glen Ct, Peoria, IL 61614-4644 | 2015-02-24 |
| 1164844262 | Kelsey Knott | Dietitian, Registered | 4125 N Sheridan Rd Ste 20, Peoria, IL 61614-7174 | 2014-01-09 |
| 1285078931 | Marilyn Bukoff Priddy | Dietitian, Registered | 1617 W Devereux Dr, Peoria, IL 61614-4009 | 2013-04-24 |
| 1992061998 | Mayuri Rangdal | Dietitian, Registered | 2640 W Stonehenge Ct, Peoria, IL 61615-7477 | 2012-04-04 |
| 1851692123 | Lauren Ashley Rusk | Dietitian, Registered | 9900 N Dalea Ln, 9212, Peoria, IL 61615-7268 | 2010-11-03 |
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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.