MRS. KELLIE FAUGHANDER WALL (NPI# 1053974337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053974337 |
| Entity Type | Individual |
| Full Name | MRS. KELLIE FAUGHANDER WALL |
| Credential | RD, CNSC |
| Practice Address |
750 E Adams St Syracuse NY 13210-2306 |
| Mailing Address |
9105 Ashley Landing Drive Clay NY 13041 |
| Practice Telephone | 2404901346 |
| Mailing Telephone | 2404901346 |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1058216 | NY | Dietary & Nutritional Service Providers |
| Street Address |
750 E ADAMS ST |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003193 | Aqeel A Sandhu | Specialist | 750 E Adams St, Syracuse, NY 13210-2306 | 2005-06-15 |
| 1770183972 | Subhashree Dasgupta | Speech-Language Pathologist | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-10-27 |
| 1841890118 | Danielle Coniglio Gonzalez | Physical Medicine & Rehabilitation | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-10-27 |
| 1497353858 | Kayleigh M Gifford | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-10-16 |
| 1578160891 | Steven Lounsbury | Physical Therapist | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-10-09 |
| 1306453295 | Sarah Persons | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-09-25 |
| 1356956270 | Carlo Manalo Dangcalan | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-09-09 |
| 1104430396 | Rida Sherwani | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-09-03 |
| 1003420803 | Michel Tawil | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-08-31 |
| 1669085056 | Komal Syeda | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-08-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194336248 | Amanda E Vadala | Dietitian, Registered | 216 Conklin Ave, Syracuse, NY 13206 | 2020-08-12 |
| 1386252716 | Gregory M Belzak | Dietitian, Registered | 108 Ormsby Dr, Syracuse, NY 13219-3117 | 2020-07-22 |
| 1871135863 | Leah Webster | Dietitian, Registered | 100 Huckleberry Ln, Syracuse, NY 13219-2114 | 2019-10-11 |
| 1376019711 | Rachel Lauren Watkins | Dietitian, Registered | 3300 James St Ste 4, Syracuse, NY 13206-2670 | 2018-10-23 |
| 1790221984 | Kathleen Mary Bump | Dietitian, Registered | 300 Halton Rd, Syracuse, NY 13224-2228 | 2017-01-11 |
| 1093017485 | Jennifer A Brady | Dietitian, Registered | 1966 S 2590 W, Syracuse, UT 84075-7022 | 2010-11-17 |
| 1518271808 | Heather Lynn Neely | Dietitian, Registered | 765 Irving Avenue, Marley Education Center, Suite 229, Syracuse, NY 13210 | 2010-07-29 |
| 1942332804 | Cynthia Todd | Dietitian, Registered | 600 S. Wilbur Ave., Horizons Clinic, Arc of Onondaga, Syracuse, NY 13204 | 2007-03-09 |
| 1770529497 | Marilyn Frances Crosby | Dietitian, Registered | 3779 Pegasus Circle, Syracuse, NY 13209-9504 | 2006-06-21 |
| 1275500621 | Donna L Acox | Dietitian, Registered | 800 S Wilbur Ave, Syracuse, NY 13204-2732 | 2006-03-03 |
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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.