Aaron Blake Kelly (NPI# 1477912129, PAC ID# 1153629498) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1477912129 |
| PAC ID by PECOS | 1153629498 |
| Professional Enrollment ID | I20160419002816 |
| Full Name | Aaron Blake Kelly |
| Organization Legal Name | ER PHYSICIAN GROUP AT JACKSON HOSPITAL |
| Address |
4250 Hospital Dr Marianna FL 32446-1917 |
| Phone Number | 8505262200 |
| Gender | M |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8729059472 |
| Number of Group Practice Members | 36 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100142 | JACKSON HOSPITAL |
| 010055 | FLOWERS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4370 W Main St, Dothan, AL 36305-1056 | 6159286268 | APP OF ALABAMA ED PLLC |
| 4250 Hospital Dr, Marianna, FL 32446-1917 | 8505262200 | ER PHYSICIAN GROUP AT JACKSON HOSPITAL |
| Organization Legal Name | ER PHYSICIAN GROUP AT JACKSON HOSPITAL |
| Physicians | 34 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard G Brunner | General Surgery | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| James Durward Tyler | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Julie R Smith | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Jirayos Chintanadilok | Pulmonary Disease | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Jacquelyn Marie Bard | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Richard M Christopher | Internal Medicine | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Holly Jo Sims | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Murali Krishna Maddipati | Internal Medicine | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Kate Frances Tyler | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Angelo R Consiglio | Otolaryngology | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Street Address |
4250 HOSPITAL DR |
| City | MARIANNA |
| State | FL |
| Zip | 32446-1917 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard G Brunner | General Surgery | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| James Durward Tyler | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Julie R Smith | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Jirayos Chintanadilok | Pulmonary Disease | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Jacquelyn Marie Bard | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Glenn L Clark | Diagnostic Radiology | Marianna Imaging, LLC | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Richard M Christopher | Internal Medicine | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Holly Jo Sims | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| David W Gullett | Certified Registered Nurse Anesthetist (crna) | Jackson Anesthesia Associates Inc | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Murali Krishna Maddipati | Internal Medicine | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory A Lambe | Chiropractic | 3894 Hwy 90, Marianna, FL 32446 | |
| Larry N. Silverman | Radiation Oncology | 21st Century Oncology, LLC | 3031 Carters Mill Rd, Marianna, FL 32446-1902 |
| David B Hurst | Radiation Oncology | 21st Century Oncology, LLC | 3031 Carters Mill Rd, Marianna, FL 32446-1902 |
| Steven H Stokes | Radiation Oncology | 21st Century Oncology, LLC | 3031 Carters Mill Rd, Marianna, FL 32446-1902 |
| Kate Frances Tyler | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Angelo R Consiglio | Otolaryngology | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| William Dennis Harris | Emergency Medicine | Small Hospital Innovations | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| April Renee Cooper | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Kristin G Fenton | Nurse Practitioner | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Steven W Spence | Internal Medicine | Er Physician Group At Jackson Hospital | 4250 Hospital Dr, Marianna, FL 32446-1917 |
| Find all physicians in zip 32446 | |||
| City | MARIANNA |
| Zip Code | 32446 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MARIANNA + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.