KELLY P KNOWLES (NPI# 1003895798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003895798 |
| Entity Type | Individual |
| Full Name | KELLY P KNOWLES |
| Other Name | KELLY PETRISON |
| Credential | MD |
| Practice Address |
159 Millburn Ave Ste 1 Millburn NJ 07041-1849 |
| Practice Telephone | 9739120155 |
| Practice Fax Number | 9739128714 |
| Mailing Telephone | 9739120155 |
| Mailing Fax Number | 9739128714 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2013-01-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 25MA06821100 | NJ | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
25MA06821100 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | BEECH ST GRP ID | 223285437 | 01 |
| NJ | BCBS MANAGED CARE PIN | K4810 | 01 |
| NJ | HEALTHNET PIN | 1K7604 | 01 |
| NJ | WELL CHOICE PIN | 4102R | 01 |
| NJ | UNITED HEALTH CARE PIN | 1997280 | 01 |
| NJ | PHCS GRP ID | 606914 | 01 |
| NJ | AMERIHEALTH PPO GRP PIN | 956005 | 01 |
| NJ | AETNA HMO GRP ID | 0501095 | 01 |
| NJ | HCPCS GRP ID | 223285437 | 01 |
| NJ | CIGNA PIN | 7182328007 | 01 |
| NJ | OXFORD PIN | P2075112 | 01 |
| NJ | HIGH MARK PA BLUE SHIELD | 001427892 | 01 |
| NJ | ANTHEM HEALTH PIN | 010068211NJ01 | 01 |
| NJ | AMERIHEALTH HMO PIN | 2113135000 | 01 |
| NJ | AETNA HMO PIN | 2532962 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700303187 | Kelly Lynn Knowles | Behavioral Analyst | 2425 Channing Way Ste B, Berkeley, CA 94704-2260 | 2017-08-25 |
| 1851326540 | Kelly S Knowles | Physical Therapist | 200 Medical St, Snead, AL 35952 | 2006-07-11 |
| 1588272835 | Kelly Jayne Knowles | Social Worker | 650 E Indian School Rd Bldg 23, Phoenix, AZ 85012-1892 | 2020-07-22 |
| Street Address |
159 MILLBURN AVE STE 1 |
| City | MILLBURN |
| State | NJ |
| Zip Code | 07041-1849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982156436 | Marisa Tusche | Social Worker | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2016-11-01 |
| 1841540507 | Keisha M Wint | Social Worker | 159 Millburn Ave, Second Floor, Millburn, NJ 07041-1849 | 2012-09-10 |
| 1568796183 | Sethi Psychiatric Associates, LLC | Clinic/Center | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2009-09-29 |
| 1023276524 | Fashion Eyewear of Essex | Eyewear Supplier (Equipment, not the service) | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2008-05-30 |
| 1457528853 | Susan Sprague-lee | Social Worker | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2008-05-14 |
| 1306066279 | Joel Robert Price | Psychiatry & Neurology | 159 Millburn Ave, 2nd Floor, Millburn, NJ 07041-1849 | 2007-04-26 |
| 1154540508 | Alan N Jacobs | Psychiatry & Neurology | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2007-04-24 |
| 1932231719 | Millburn Pediatrics Pa | Pediatrics | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2007-03-09 |
| 1649311259 | Allan J. Hermann | Psychiatry & Neurology | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2007-02-08 |
| 1265579577 | Gayle S Shulman Md, LLC | Ophthalmology | 159 Millburn Ave, Millburn, NJ 07041-1849 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932696879 | Michael J. Kahn | Psychologist | 114 Millburn Avenue, Suite Number 200, Millburn, NJ 07041 | 2018-04-17 |
| 1780063586 | Beth Israel Medicial Center | General Acute Care Hospital | 927 Ridgewood Road, Millburn, NJ 07041 | 2015-05-26 |
| 1457762577 | Amy Ladetsky | Occupational Therapist | 25 Greenwood Drive, Millburn, NJ 07041 | 2014-05-12 |
| 1033384193 | Doris Marie Breckenridge | Psychiatry & Neurology | 116 Millburn Avenue, Suite 200, Millburn, NJ 07041 | 2008-04-29 |
| 1477722627 | M. Mai-tram D. Ho | Chiropractor | 58 Mountain Ave, Millburn, NJ 07041 | 2008-02-21 |
| 1689880320 | Wendy Caroline Wisz | Dentist | 250 Millburn Ave., Millburn, NJ 07041 | 2007-05-16 |
| 1578775680 | Margaret M Mcintyre | Dentist | 421 Essex St, Millburn, NJ 07041 | 2007-05-03 |
| 1225189210 | Regina Ann Schaefer | Social Worker | 55 Bleeker Street, Millburn, NJ 07041 | 2007-01-16 |
| 1124188800 | Patricia Ann Delgaldo | Social Worker | 368 Essex Street, 2nd Floor, Millburn, NJ 07041 | 2006-12-11 |
| 1366541690 | Mahesh R Desai | Internal Medicine | 120 Millburn Avenue, Suite M2, Millburn, NJ 07041 | 2006-09-22 |
| Find all providers in zip 07041 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669628079 | Thomas Richard Walters | Pediatrics | 130 Greenwood Dr, Millburn, NJ 07041-1447 | 2008-08-18 |
| 1568513943 | Melissa M Brown | Pediatrics | 241 Millburn Ave, Suite B, Millburn, NJ 07041-1739 | 2007-01-14 |
| 1467454066 | Ann Marie Comandatore | Pediatrics | 90 Millburn Ave, Suite 101, Millburn, NJ 07041-1945 | 2005-08-12 |
| 1811452337 | Buono Pediatrics and Wellness | Pediatrics | 171 Millburn Ave, Millburn, NJ 07041-1825 | 2019-02-08 |
| 1316257942 | Shruti Chakrabarti Ramesh | Pediatrics | 90 Millburn Ave, Suite 101, Millburn, NJ 07041-1945 | 2010-10-17 |
| 1881902799 | Amy C Buono | Pediatrics | 171 Millburn Ave, Millburn, NJ 07041-1825 | 2010-09-14 |
| 1912134289 | Stacy Ellen Thompson | Pediatrics | 90 Millburn Ave, Suite 101, Millburn, NJ 07041-1945 | 2009-06-15 |
| 1295783421 | Yanina Meshko | Pediatrics | 90 Millburn Ave, Suite 101, Millburn, NJ 07041-1933 | 2006-05-04 |
| 1104874148 | Sharon Spiteri | Pediatrics | 90 Millburn Ave, Suite 101, Millburn, NJ 07041-1945 | 2006-05-04 |
| 1689656225 | Sandra R Voremberg | Pediatrics | 120 Millburn Ave, Ste M1, Millburn, NJ 07041-1942 | 2005-11-18 |
| Find all providers in MILLBURN | ||||
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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.