JAMES PATRICK THOMAS KELLEY (NPI# 1902361611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902361611 |
| Entity Type | Individual |
| Full Name | JAMES PATRICK THOMAS KELLEY |
| Credential | NP |
| Practice Address |
1200 E Main St Ste 12 Spartanburg SC 29307-1738 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645609260 |
| Practice Fax Number | 8645609265 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2020-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 22319 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
22319 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PIN | SCE6826084 | 01 |
| SC | MEDICARE PIN | SCE6826067 | 01 |
| SC | MEDICARE PIN | SCE6826121 | 01 |
| SC | MEDICARE PIN | SCE682J577 | 01 |
| SC | NP5742 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376875294 | James Taylor Kelley | Pharmacist | 3945 Pole Line Rd, Attn: Pharmacy, Pocatello, ID 83201-5425 | 2010-02-02 |
| 1669640793 | James Edward Kelley II | Dentist | 1065 Johnnie Dodds Blvd Ste E, Mt Pleasant, SC 29464-6153 | 2008-02-11 |
| 1508087891 | James Kelley | Physical Therapist | 3137 Woodland Ct N, North Tonawanda, NY 14120-1154 | 2007-05-02 |
| 1285858159 | James M Kelley | Preventive Medicine | 3300 E Interstate 40, Suite 400, Amarillo, TX 79103-4801 | 2007-04-12 |
| 1831259050 | James P Kelley | Optometrist | 1727 Rt 27, Somerset, NJ 08873 | 2006-12-11 |
| 1033210240 | James E Kelley | Dentist | 5555 N Mesa St Ste 300, El Paso, TX 79912-5487 | 2006-09-26 |
| 1891757357 | James L Kelley | Pharmacist | 104 Holly St, Mc Gehee, AR 71654-2249 | 2006-04-03 |
| 1447646906 | James Joseph Kelley Iv | Urology | 2900 Acme Brick Plz, Fort Worth, TX 76109-4123 | 2015-04-11 |
| 1881093698 | James Kelley | Physical Therapist | 75 Francis St, Asb II First Floor, Boston, MA 02115-6110 | 2014-08-18 |
| 1770902421 | James Fitzhugh Kelley | Family Medicine | 1001 S George St, Bldg Mkb, York, PA 17403-3676 | 2014-04-09 |
| Street Address |
1200 E MAIN ST STE 12 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29307-1738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265430078 | Michael Joseph Bell | Family Medicine | 1200 E Main St Ste 12, Spartanburg, SC 29307-1738 | 2005-07-14 |
| 1598318966 | Sally Catherine Donnelly | Nurse Practitioner | 1200 E Main St Ste 12, Spartanburg, SC 29307-1738 | 2019-07-24 |
| 1871960104 | Melissa Lynn Hawver | Physician Assistant | 1200 E Main St Ste 12, Spartanburg, SC 29307-1738 | 2015-08-21 |
| 1528451002 | Katherine Elizabeth Enos | Family Medicine | 1200 E Main St Ste 12, Spartanburg, SC 29307 | 2015-03-09 |
| 1194705970 | Gary D. Rauch | Family Medicine | 1200 E Main St Ste 12, Spartanburg, SC 29307-1738 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
| 1194247528 | Tawnia Lee Prince | Occupational Therapy Assistant | 110 Summit Knoll Drive, Spartanburg, SC 29307 | 2017-07-07 |
| 1730633553 | Laura K Taylor | Chiropractor | 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 | 2016-08-10 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1316312010 | Joy Rogers | Speech-Language Pathologist | 175 Burdette St, Spartanburg, SC 29307 | 2015-12-07 |
| 1376923169 | Olivia Conrad | Speech-Language Pathologist | 220 Sloans Grove Rd, Spartanburg, SC 29307 | 2015-06-05 |
| 1457755118 | Optimal Radiology Partners of Virginia, Pllc | Radiology | 75 Skylyn Drive, Spartanburg, SC 29307 | 2014-10-09 |
| 1295033272 | Sean Quinn | Pharmacist | 790 East Main Street, Spartanburg, SC 29307 | 2011-03-01 |
| 1417250887 | James Edward Bradof | Internal Medicine | 212 Cypress Creek Drive, Spartanburg, SC 29307 | 2010-12-07 |
| 1528388030 | Tanya Tocharoen Tang | Internal Medicine | 126 Dillon Dr., Spartanburg, SC 29307 | 2010-06-07 |
| Find all providers in zip 29307 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231625 | Trisha Slaughter | Nurse Practitioner | 610 Adelaide Dr, Spartanburg, SC 29301-3231 | 2020-06-30 |
| 1891323457 | Jonathan Douglas Tester | Nurse Practitioner | 220 Police Club Rd, Spartanburg, SC 29303-3402 | 2020-03-30 |
| 1215455944 | Jasmine Marie Gregory | Nurse Practitioner | 300 E Blackstock Rd Ste E, Spartanburg, SC 29301-3787 | 2017-09-01 |
| 1730600396 | Stephanie Cannon | Nurse Practitioner | 100 E Wood St Ste 202, Spartanburg, SC 29303-3058 | 2017-07-03 |
| 1538698030 | Deborah Temples Anderson | Nurse Practitioner | 11 Doctors Park Dr Ste 220, Spartanburg, SC 29307-1008 | 2017-06-08 |
| 1285181990 | Faustina Baafour Evans | Nurse Practitioner | 1855 E Main St Ste 21a, Spartanburg, SC 29307-2327 | 2016-09-10 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1992170807 | Jaime Bright | Nurse Practitioner | 301 E Wood St, Spartanburg, SC 29303-3020 | 2015-12-02 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29307 |
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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.