Jennifer M Kelly (NPI# 1962804880, PAC ID# 5395052112) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1962804880 |
| PAC ID by PECOS | 5395052112 |
| Professional Enrollment ID | I20150910002877 |
| Full Name | Jennifer M Kelly |
| Organization Legal Name | CLEANSLATE MEDICAL GROUP OF KENTUCKY PLLC |
| Address |
210 E Gray St Suite 803 Louisville KY 40202-3904 |
| Phone Number | 4135842173 |
| Gender | F |
| Medical School | UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4486909769 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180088 | NORTON HOSPITALS, INC |
| Address | Phone | Organization |
|---|---|---|
| 210 E Gray St, Suite 803, Louisville, KY 40202-3904 | 4135842173 | CLEANSLATE MEDICAL GROUP OF KENTUCKY PLLC |
| 315 E Broadway, Suite 185 C, Louisville, KY 40202-3702 | 5026295455 | COMMUNITY MEDICAL ASSOCIATES INC |
| 9733 3rd St Rd, Louisville, KY 40272-2603 | 4135842173 | CLEANSLATE MEDICAL GROUP OF KENTUCKY PLLC |
| Organization Legal Name | CLEANSLATE MEDICAL GROUP OF KENTUCKY PLLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan Ann Cramer | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 9733 3rd St Rd, Louisville, KY 40272-2603 |
| Sandra L Breeding | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 1500 Leestown Rd, Suite 110, Lexington, KY 40511-2071 |
| Craig Douglas Rouben | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| James Anthony Holder | Family Medicine | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| Catherine Collins | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| Layla Nadir Al-shami | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| Daniel James Cheney | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| Susan Staples | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| Autumn C Allgeier | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 9733 3rd St Rd, Louisville, KY 40272-2603 |
| Street Address |
210 E GRAY ST SUITE 803 |
| City | LOUISVILLE |
| State | KY |
| Zip | 40202-3904 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Whitney Spear | Nurse Practitioner | Community Medical Associates Inc | 210 E Gray St, Louisville, KY 40202-3903 |
| Manford A Wright | Internal Medicine | Community Medical Associates Inc | 210 E Gray St, Suite 700, Louisville, KY 40202-3903 |
| Cyna Khalily | Orthopedic Surgery | Community Medical Associates Inc | 210 E Gray St, Suite 600, Louisville, KY 40202-3902 |
| Craig Douglas Rouben | Nurse Practitioner | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| James Anthony Holder | Family Medicine | Cleanslate Medical Group of Kentucky Pllc | 210 E Gray St, Suite 803, Louisville, KY 40202-3904 |
| Andrea J Johnson | Physical Therapy | Sn Kentuckiana Rehab LLC | 210 E Gray St, Suite 807, Louisville, KY 40202-3927 |
| Jeffrey H Frank | Neurology | Community Medical Associates Inc | 210 E Gray St, Suite 1002, Louisville, KY 40202-3906 |
| Julianne Green | Pediatric Medicine | University of Louisville Physicians, Inc | 210 E Gray St, Louisville, KY 40202-3906 |
| Stacey L Roberts | Nurse Practitioner | Community Medical Associates Inc | 210 E Gray St, Suite 1002, Louisville, KY 40202-3906 |
| Divyesh R Bhakta | Interventional Cardiology | Community Medical Associates Inc | 210 E Gray St, Suite 1002, Louisville, KY 40202-3906 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aaron Becker | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Elizabeth A Mills | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Barry R Pecha | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Ryan J Malone | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Stephan J Sweitzer | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Kelly M Gollar | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| David H Rosenbaum | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Richard N Medley Iii | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Stephanie A Corbett | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Stephanie A Flaspoehler | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Find all physicians in zip 40202 | |||
| City | LOUISVILLE |
| Zip Code | 40202 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LOUISVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jennifer M Kelly.
| 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.