DAVID ANDREW KELLENBERGER (NPI# 1073632410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073632410 |
| Entity Type | Individual |
| Full Name | DAVID ANDREW KELLENBERGER |
| Credential | PA, RD |
| Practice Address |
800 E Dawson St Tyler TX 75701-2036 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9036064129 |
| Mailing Telephone | 9033246400 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | DT81736 | TX | Dietary & Nutritional Service Providers |
| Y | 363A00000X | Physician Assistant | PA04525 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE | 1G0179 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3124 W Highway 22, Corsicana, TX 751102435 | 9036414270 | |
| 3201 Corsicana Crossings Blvd Ste 101, Corsicana, TX 751099302 | 9038726065 | |
| 505 S Nolen Dr, Suite A, Southlake, TX 760929167 | 8174241525 | 8174243491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528105574 | David Kellenberger | Chiropractor | 2140 W Poplar Ave Ste 107, Collierville, TN 38017 | 2007-01-31 |
| Street Address |
800 E DAWSON ST |
| City | TYLER |
| State | TX |
| Zip Code | 75701-2036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051705 | Mohammad K Khedr | Internal Medicine | 800 E Dawson St, Tyler, TX 75701-2036 | 2005-05-31 |
| 1174130462 | Jessica Lemoine Phillips | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-09-30 |
| 1275148116 | Erika Anne Heffner | Pharmacist | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-09-08 |
| 1750995684 | Christine Vo | Pharmacist | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-09-08 |
| 1366051526 | Bessie Burchfield | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-07-23 |
| 1952929366 | Amy Elizabeth Enlow | Registered Nurse | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-07-13 |
| 1033739388 | Eric Bradley Vogt | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-04-16 |
| 1780212084 | Carolyn Victoria Hamilton | Registered Nurse | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-03-31 |
| 1548800022 | Jasmine Azghani Vardeman | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-01-13 |
| 1346889383 | Kathy A Glem | Pharmacist | 800 E Dawson St, Tyler, TX 75701-2036 | 2019-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129997 | Elizabeth Niedrauer | Physician Assistant | 2314 S Kennedy Ave, Tyler, TX 75701-5242 | 2020-06-25 |
| 1629489042 | Lifetime Health Center | Physician Assistant | 1420 Wsw Loop 323, Suite 100, Tyler, TX 75701-9347 | 2014-05-20 |
| 1407273428 | East Texas Physician Assistant Services | Physician Assistant | 5380 Old Bullard Rd Ste 600-125, Tyler, TX 75703-3607 | 2014-03-27 |
| 1023356524 | Vitality Center | Physician Assistant | 14444 Eastside Rd, Tyler, TX 75707-6724 | 2013-01-18 |
| 1790029007 | John M Mclean | Physician Assistant | 3700 Mcdonald Rd, Apt 260, Tyler, TX 75701-6253 | 2012-11-27 |
| 1124058524 | David Beck | Physician Assistant | 1133 Medical Dr, Tyler, TX 75701-2130 | 2006-07-03 |
| 1467444141 | Thomas R Scholler | Physician Assistant | 703 S Fleishel Ave, Tyler, TX 75701-2015 | 2005-08-18 |
| 1376535054 | Stephanie S Carter | Physician Assistant | 703 S Fleishel Ave Ste 4000, Tyler, TX 75701 | 2005-08-18 |
| 1992797799 | Matthew M Hand | Physician Assistant | 619 S Fleishel Ave, Suite 101, Tyler, TX 75701-2004 | 2005-08-17 |
| 1518962299 | Nina Beth Partin | Physician Assistant | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2005-06-17 |
| Find all providers in TYLER | ||||
Please comment or provide details below to improve the information on DAVID ANDREW KELLENBERGER.
| 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.