SHELBY LARAY KELLEY (NPI# 1952932881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952932881 |
| Entity Type | Individual |
| Full Name | SHELBY LARAY KELLEY |
| Practice Address |
777 Hemlock St Macon GA 31201-2102 |
| Mailing Address |
132 Mapleton Forest Dr Nw Cleveland TN 37312-6240 |
| Practice Telephone | 4786331000 |
| Mailing Telephone | 4236507667 |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
777 HEMLOCK ST |
| City | MACON |
| State | GA |
| Zip Code | 31201-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467452375 | Sandra E Moore | Pediatrics | 777 Hemlock St, Msc 83, Macon, GA 31201-2102 | 2005-07-21 |
| 1740881796 | Daquanda Arnett | Registered Nurse | 777 Hemlock St, Macon, GA 31201-2102 | 2020-11-05 |
| 1538770383 | Laquanna Foster | Nurse Practitioner | 777 Hemlock St, Macon, GA 31201-2102 | 2020-08-14 |
| 1669081113 | Sabrina L. Singleton | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2020-07-29 |
| 1528686003 | Jonathan Michael Clopton | Nurse Practitioner | 777 Hemlock St, Macon, GA 31201-2102 | 2020-07-10 |
| 1194348623 | Samay Bhushan | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-05-19 |
| 1184247785 | Andrew Tyler Barnes | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-05-19 |
| 1922627108 | Gwenda Faye Canady | Registered Nurse | 777 Hemlock St, Macon, GA 31201-2102 | 2020-04-08 |
| 1376172536 | Hannah Batten | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-04-08 |
| 1225667587 | Michael T Stevens | Student in an Organized Health Care Education/Training Program | 777 Hemlock St, Macon, GA 31201-2102 | 2020-04-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
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| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801446455 | Mednax | Anesthesiologist Assistant | 770 Pine St Ste L40, Macon, GA 31201-7521 | 2019-09-16 |
| 1689895591 | David Luce | Anesthesiologist Assistant | 777 Hemlock Street, Macon, GA 31201 | 2007-05-01 |
| 1306814249 | Catherine D Davis | Anesthesiologist Assistant | 624 Bellgrove Pt, Macon, GA 31220-7621 | 2006-03-08 |
| 1669081113 | Sabrina L. Singleton | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2020-07-29 |
| 1407494636 | Tyler Brice Akins | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2019-12-18 |
| 1205486362 | Alie Mulkey | Anesthesiologist Assistant | 770 Pine St Ste L40, Macon, GA 31201-7521 | 2019-09-19 |
| 1548778392 | Samantha Ryce Dillon | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2018-01-15 |
| 1306356860 | Jesse Michael | Anesthesiologist Assistant | 380 Hospital Dr Ste 410, Macon, GA 31217-8014 | 2017-10-10 |
| 1487106548 | Caitlin Emily George | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2016-10-25 |
| 1568913903 | Charles Bennett Winter | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2016-10-20 |
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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.