MS. JENNIFER SUZANNE KELLY (NPI# 1881802627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881802627 |
| Entity Type | Individual |
| Full Name | MS. JENNIFER SUZANNE KELLY |
| Credential | M.D. |
| Practice Address |
19250 Sw 65th Ave Ste 300 Tualatin OR 97062-7452 |
| Mailing Address |
7650 Sw Beveland Rd Suite 200 Portland OR 97223-8692 |
| Practice Telephone | 5036921242 |
| Practice Fax Number | 5036913615 |
| Mailing Telephone | 5036921242 |
| Mailing Fax Number | 5036913615 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2016-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | MD 27685 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500623446 | 05 | |
| OR | MEDICARE PTAN | R157973 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881216463 | Jennifer Kelly | Nurse Practitioner | 7595 Affirmed Ct, Lewis Center, OH 43035-9143 | 2020-05-17 |
| 1790322758 | Jennifer Lee Kelly | Home Health Aide | 4519 Stanbrook Dr, North Chesterfield, VA 23234-4021 | 2019-12-09 |
| 1396386744 | Jennifer Eileen Kelly | Specialist | 2354 Ocean Ave, Ronkonkoma, NY 11779-6578 | 2019-10-07 |
| 1659936813 | Jennifer Noel Kelly | Behavior Technician | 3287 N Mayfield Ave, San Bernardino, CA 92405-2627 | 2019-05-03 |
| 1851784284 | Jennifer Kelly | Occupational Therapy Assistant | 1215 Gainsboro Rd, Bala Cynwyd, PA 19004-2014 | 2015-03-10 |
| 1952706699 | Jennifer Kelly | Pharmacist | 1701 Welsh Rd Ste 5, Philadelphia, PA 19115-3172 | 2014-10-23 |
| 1750791257 | Jennifer Kelly | Psychologist | 11 Brooklands Apt Gi, Bronxville, NY 10708-3512 | 2014-05-06 |
| 1851722995 | Jennifer L. Kelly | Speech-Language Pathologist | 555 Anthony Wayne Trail, Waterville, OH 43566 | 2013-11-27 |
| 1144598343 | Jennifer Elaine Kelly | Physician Assistant | 381 Park Avenue South, Suite 1020, New York, NY 10016 | 2011-12-02 |
| 1063789030 | Jennifer Zucal Kelly | Registered Nurse | 215 E 5th St, Emporium, PA 15834-1417 | 2011-11-18 |
| Street Address |
19250 SW 65TH AVE STE 300 |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-7452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932100526 | Meridian Family Care, LLC | Family Medicine | 19250 Sw 65th Ave, Ste 265, Tualatin, OR 97062-7452 | 2005-08-03 |
| 1285168872 | Radiation Oncology Specialists PC | Clinic/Center | 19250 Sw 65th Ave, Suite 220, Tualatin, OR 97062-7452 | 2017-04-20 |
| 1750834545 | Jane Elizabeth Adkins Nath | Advanced Practice Midwife | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2016-07-27 |
| 1356717359 | Dana Jones Ulrich | Nurse Practitioner | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2015-08-13 |
| 1952791501 | Lauren Metzger | Social Worker | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2015-02-03 |
| 1346682390 | Dorothy Nell Knapp | Psychologist | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2013-07-18 |
| 1841639887 | Marisa Rose Bryman | Advanced Practice Midwife | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2013-06-24 |
| 1548555451 | Brenda C. Brewer | Nurse Practitioner | 19250 Sw 65th Ave, Tualatin, OR 97062-7452 | 2011-06-20 |
| 1346536299 | Adam N Glaser | Internal Medicine | 19250 Sw 65th Ave, Suite 110, Tualatin, OR 97062-7452 | 2011-06-20 |
| 1689967994 | Marceea Genea Hanlin | Physical Therapist | 19250 Sw 65th Ave, Medical Plaza #1, Suite 125, Tualatin, OR 97062-7452 | 2011-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558322032 | Eryn Bethany Applegate | Obstetrics & Gynecology | 19250 Sw 65th Ave Ste 300, Tualatin, OR 97062-7707 | 2006-04-01 |
| 1760724090 | Jessica Diane Fowler | Obstetrics & Gynecology | 19250 Sw 65th Ave Ste 300, Tualatin, OR 97062-7707 | 2013-03-25 |
| 1306011259 | Maryam Hadiashar | Obstetrics & Gynecology | 19250 Sw 65th Ave, Suite 325, Tualatin, OR 97062-7452 | 2008-04-22 |
| 1194822163 | Lori Lea Goranson | Obstetrics & Gynecology | 19250 Sw 65th Ave, Ste 300, Tualatin, OR 97062-7452 | 2006-09-20 |
| 1205819893 | Harold G Vick | Obstetrics & Gynecology | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2005-11-28 |
| 1407839376 | Daniel C Schrinsky | Obstetrics & Gynecology | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2005-11-23 |
| 1710969340 | Gina R Allison | Obstetrics & Gynecology | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2005-11-18 |
| 1477535003 | Anton K Broms | Obstetrics & Gynecology | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2005-11-18 |
| 1861474843 | Marguerite R Stewart | Obstetrics & Gynecology | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2005-11-16 |
| 1871574103 | Andrea C Olmstead | Obstetrics & Gynecology | 19250 Sw 65th Ave, Suite 300, Tualatin, OR 97062-7452 | 2005-11-14 |
| Find all providers in TUALATIN | ||||
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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.