DR. BENJAMIN J KELLY (NPI# 1073599833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073599833 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN J KELLY |
| Credential | M.D. |
| Practice Address |
100 Stoneforest Dr Ste 320 Woodstock GA 30189-4881 |
| Mailing Address |
100 Stoneforest Dr 320 Woodstock GA 30189-4881 |
| Practice Telephone | 7705165199 |
| Practice Fax Number | 6782131851 |
| Mailing Telephone | 7705165199 |
| Mailing Fax Number | 6782131851 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2015-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 48120 | GA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649810888 | Benjamin Orrin Kelly | Occupational Therapist | 5005 North Piedras Street, El Paso, TX 79920 | 2020-01-15 |
| Street Address |
100 STONEFOREST DR STE 320 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189-4881 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215191085 | Atlanta North Dermatology & Skin Care, Inc. | Dermatology | 100 Stoneforest Dr Ste 320, Woodstock, GA 30189-4881 | 2008-07-10 |
| 1407893217 | Katie Bodycomb Covington | Physician Assistant | 100 Stoneforest Dr Ste 320, Woodstock, GA 30189-4881 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851848766 | Heaven's Gait Therapeutic Riding, Inc | Specialist | 2471 E Cherokee Dr, Woodstock, GA 30188-2000 | 2016-09-08 |
| 1710344882 | Susan Marini | Specialist | 232 Hiawassee Dr, Woodstock, GA 30188-7851 | 2016-01-20 |
| 1982903803 | Spectrum Support LLC | Specialist | 1575 West Lake Shore Drive, Woodstock, IL 60098 | 2011-03-17 |
| 1497060016 | Quality Medical Management Services LLC | Specialist | 1112 Dunedin Trl, Woodstock, GA 30188-3657 | 2010-08-09 |
| 1851537955 | Kimberly Renee Muschong | Specialist | 2285 Applewood Ln, Woodstock, IL 60098-7487 | 2008-12-21 |
| 1013161637 | 360 Medical Management | Specialist | 200 Parkbrooke Dr, Suite 200, Woodstock, GA 30189-6331 | 2008-11-10 |
| 1255590386 | Karen D Manire | Specialist | 7210 Highway 92, Woodstock, GA 30189-3406 | 2008-06-04 |
| 1326269564 | Bridgemill Neurological Associates, PC | Specialist | 980 Woodstock Parkway, Suite 300, Woodstock, GA 30188 | 2007-05-02 |
| 1053532838 | Irene Brigetta Reece | Specialist | 104 Springfield Center Drive, Suite 117, Woodstock, GA 30188 | 2007-05-01 |
| 1114067634 | Daniel Milton Frajt | Specialist | 2026 Township Dr, Woodstock, GA 30189-5243 | 2007-02-07 |
| Find all providers in WOODSTOCK | ||||
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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.