MISS KELLY O'MELIA (NPI# 1952849382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952849382 |
| Entity Type | Individual |
| Full Name | MISS KELLY O'MELIA |
| Practice Address |
681 Clarkson Ave Brooklyn NY 11203-2125 |
| Mailing Address |
14202 20th Ave Flushing NY 11351-3000 |
| Practice Telephone | 3478046007 |
| Mailing Telephone | 3478046007 |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
681 CLARKSON AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11203-2125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457431546 | Dhananjay A Bhagogi | Internal Medicine | 681 Clarkson Ave, Building 2, Brooklyn, NY 11203-2125 | 2006-10-16 |
| 1588295034 | Victoria Tayese | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2020-02-03 |
| 1548806979 | William Brown | Student in an Organized Health Care Education/Training Program | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-11-20 |
| 1295378461 | Racheal Olufunke Ajiboye | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-10-21 |
| 1194367854 | Rose Boutin | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-10-15 |
| 1508407875 | Nathaniel Ajibade | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2199 | 2019-10-08 |
| 1316588684 | Modupe Kolawole | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2199 | 2019-10-08 |
| 1861033359 | Irshad Amirali Sumar | Psychiatry & Neurology | 681 Clarkson Ave, Brooklyn, NY 11203-2199 | 2019-10-05 |
| 1710528799 | Corazon Tapere Ty | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-10-01 |
| 1043851215 | Raisa Suelyn Harrington | Registered Nurse | 681 Clarkson Ave, Brooklyn, NY 11203-2125 | 2019-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615747 | Winnie Ming Wong | Dance Therapist | 451 Clarkson Ave R Building, Idd/mh Unit, R5west, Brooklyn, NY 11203 | 2020-10-06 |
| 1174134803 | Jermiah Jonoah Jones | Social Worker | 307 E 54th St, 3, Brooklyn, NY 11203 | 2020-08-14 |
| 1780201566 | Jesvin Jeyapaulraj | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate, General Surgery Department, Brooklyn, NY 11203 | 2020-06-29 |
| 1881219731 | Natasha Thomas | Specialist | 140 East 52nd St Brooklyn, Apt 1r, Brooklyn, NY 11203 | 2020-06-16 |
| 1679197396 | Syed Hamza Bin Waqar | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Msc 50, Suny Downstate, Brooklyn, NY 11203 | 2020-05-29 |
| 1013536846 | Isaak Rubinov | Student in an Organized Health Care Education/Training Program | 91 E 39th St, Brooklyn, NY 11203 | 2020-04-12 |
| 1932733615 | Shade Celestine | Specialist | 293 East53rd Street, Brooklyn, NY 11203 | 2020-03-03 |
| 1023656147 | Shenez Brutus | Nurse Practitioner | Suny Downstate College of Nursing, 450 Clarkson Avenue, Brooklyn, NY 11203 | 2019-12-19 |
| 1215586425 | Terry-ann Lee | Registered Nurse | 440 East 45th Street, Kings, NY 11203 | 2019-09-10 |
| 1568023828 | Mmeyeneabasi David Omede | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate Medical Center, Brooklyn, NY 11203 | 2019-06-26 |
| Find all providers in zip 11203 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669099826 | Moseka Turkessa James | Peer Specialist | 1220 Remsen Ave # 1, Brooklyn, NY 11236-3925 | 2020-07-02 |
| 1225659923 | Renee S Peterkin | Peer Specialist | 1016 Ralph Ave, Brooklyn, NY 11236-1258 | 2020-05-04 |
| 1639704984 | Henry Smith | Peer Specialist | 236 Fountain Ave, Brooklyn, NY 11208-2516 | 2020-03-06 |
| 1811530595 | Shernold Michaud | Peer Specialist | 195 Montague Steet, Condo Unit K, 8th Floor, Brooklyn, NY 11201-3628 | 2019-10-24 |
| 1316592066 | Felix Alexander Barbour | Peer Specialist | 25 Flatbush Ave Ste 3, Brooklyn, NY 11217-2499 | 2019-08-08 |
| 1386019321 | Marta Josephine Jablonka I | Peer Specialist | 137 Dewitt Ave, Brooklyn, NY 11207 | 2015-12-02 |
| 1093186199 | Isaac Trieger | Peer Specialist | 1118 45th St Apt 1r, Brooklyn, NY 11219-2192 | 2015-10-14 |
| 1447859574 | Lynnedell Felinor | Peer Specialist | 2037 Utica Ave Ste 2, Brooklyn, NY 11234-3234 | 2020-10-20 |
| 1336746098 | Yeimi Felix | Peer Specialist | 1623 Kings Hwy, Brooklyn, NY 11229-1209 | 2020-10-06 |
| 1366057507 | Sean Alexander | Peer Specialist | 25 Flatbush Ave Ste 3, Brooklyn, NY 11217-2499 | 2020-09-14 |
| Find all providers in BROOKLYN | ||||
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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.