SAMUEL KELLY (NPI# 1013542372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013542372 |
Entity Type | Individual |
Full Name | SAMUEL KELLY |
Practice Address |
100 Hillcrest Medical Blvd Waco TX 76712-8897 |
Mailing Address |
Po Box 844658 Dallas TX 75284-4658 |
Practice Telephone | 2542022000 |
Mailing Telephone | 2547242111 |
Enumeration Date | 2020-03-06 |
Last Update Date | 2020-07-02 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 367H00000X | Anesthesiologist Assistant | 32697602 | TX | Physician Assistants & Advanced Practice Nursing Providers |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437179603 | Samuel S. Kelly | Family Medicine | 5826 Samet Dr, High Point, NC 27265-3660 | 2006-07-20 |
1174523377 | Samuel James Kelly IIi | Social Worker | 200 E Joppa Rd, Suite 108, Towson, MD 21286-3150 | 2005-07-28 |
1669092318 | Samuel Kelly | Behavior Technician | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2020-04-23 |
1265991442 | Samuel Kelly | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2019-03-18 |
1174018022 | Samuel Robert Kelly | Dentist | 3380 Astoria Way Ne, Salem, OR 97305-1667 | 2018-06-23 |
1831690940 | Samuel Kelly | Physical Therapist | 1411 Woodbourne Rd Ste B, Levittown, PA 19057-1540 | 2018-02-23 |
1669797171 | Samuel E Kelly | Counselor | 2901 W Oakland Park Blvd, Ste A1, Oakland Park, FL 33311-1243 | 2010-03-29 |
Street Address |
100 HILLCREST MEDICAL BLVD |
City | WACO |
State | TX |
Zip Code | 76712-8897 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639177462 | Tamsak Kanoklukul | Nurse Anesthetist, Certified Registered | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2005-07-14 |
1851992184 | Heather Ann Johnson | Registered Nurse | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2020-11-03 |
1902457047 | Megan R Fortenberry | Nurse Practitioner | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-09-20 |
1275188732 | Betty Jean Gonzalez | Nurse Practitioner | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-08-01 |
1073166559 | Ricardo G Altahif Jr. | Occupational Therapist | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-07-23 |
1184286148 | Julia Melee Jones | Physician Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-06-30 |
1194386870 | Daniel Roy Beane | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-06-24 |
1376100875 | Meryl Lee Boutte | Anesthesiology | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-05-21 |
1982178018 | Kenneth James Roeger | Nurse Anesthetist, Certified Registered | 100 Hillcrest Medical Blvd, Waco, TX 76712 | 2019-01-11 |
1861965329 | Allison Joy Vickers | Speech-Language Pathologist | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-01-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922634294 | Waco Ophthalmology, Pllc | Ophthalmology | 602 W Highway 6, Waco, TX 76712 | 2020-03-19 |
1326692872 | Oceans Behavioral Hospital of Waco LLC | Psychiatric Hospital | 5931 Crosslake Parkway, Waco, TX 76712 | 2019-08-01 |
1831759620 | Jessica Ngoc Vien | Optometrist | 1000 Hwy 6, Ste 210, Waco, TX 76712 | 2019-06-14 |
1780150888 | Chelsea Cannon | Occupational Therapist | 330 W State Hwy 6, Waco, TX 76712 | 2018-10-17 |
1669955399 | Elizabeth Ann Barnhill | Speech-Language Pathologist | 15003 Riatta Rd, Woodway, TX 76712 | 2018-09-09 |
1447731617 | Melanie A Melton | Physical Therapist | 300 West Highway 6, Waco, TX 76712 | 2018-08-27 |
1396226403 | Gala Kaye Czajkoski | Occupational Therapy Assistant | 300 West Hightway 6, Waco, TX 76712 | 2018-08-27 |
1619457454 | Monica Anderson | Physical Therapy Assistant | 300 W Hwy 6, Waco, TX 76712 | 2018-08-21 |
1295238368 | Waco Sn Opco LLC | Skilled Nursing Facility | 7501 Bagby, Waco, TX 76712 | 2018-03-14 |
1558872952 | C. Guy Fps, Pllc | Otolaryngology | 1129 Aberdeen Rd, Waco, TX 76712 | 2017-10-12 |
Find all providers in zip 76712 |
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 |
---|---|---|---|---|
1194386870 | Daniel Roy Beane | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-06-24 |
1972042224 | Benjamin Morgan | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2017-02-20 |
1235526310 | Whitney Ankrum | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2015-04-16 |
1639599103 | Chad Patete | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2014-04-23 |
1356767917 | Rebecca Jane Osborne | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2014-03-06 |
1518301365 | Sylvia Monica Skucha | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2013-04-23 |
1598098287 | Jeffrey T Mims | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2009-09-12 |
1215170584 | Miguel Aguirre | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2009-04-15 |
1750379640 | Alan Sims | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712 | 2005-10-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124642509 | George Ezzat Nicolas | Anesthesiologist Assistant | 6308 El Risco St, El Paso, TX 79912-2508 | 2020-06-02 |
1982244315 | Allied Anesthesia Pllc | Anesthesiologist Assistant | 12801 N Central Expy Ste 750, Dallas, TX 75243-1876 | 2020-01-14 |
1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
1215497508 | Bd Anesthesia Associates Pllc | Anesthesiologist Assistant | 2024 W 15th St # F-364, Plano, TX 75075-7363 | 2019-03-22 |
1336647874 | Charlie Phung | Anesthesiologist Assistant | 6431 Fannin St Ste 5020, Houston, TX 77030-1501 | 2018-01-30 |
1245765395 | Ashley Balinski | Anesthesiologist Assistant | 807 Bay Ave, Unit A, Kemah, TX 77565-2972 | 2017-04-26 |
1669922472 | Au Monitoring LLC | Anesthesiologist Assistant | 7445 Las Colinas Blvd, Irving, TX 75063-7561 | 2016-10-05 |
1548620594 | Danielle Michelle Brooks | Anesthesiologist Assistant | 12418 Dawn Terrace, Houston, TX 77048 | 2016-03-03 |
1982074449 | Faa Servicespllc | Anesthesiologist Assistant | 11700 Preston Rd Ste 660-154, Dallas, TX 75230-6112 | 2015-09-28 |
1982070074 | Thomas Kennelly | Anesthesiologist Assistant | 6720 Bertner Ave # 226, Houston, TX 77030-2604 | 2015-08-12 |
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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.