KELLY G. GWATHMEY (NPI# 1073716775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073716775 |
| Entity Type | Individual |
| Full Name | KELLY G. GWATHMEY |
| Credential | M.D. |
| Practice Address |
11958 W Broad St Henrico VA 23233-1007 |
| Mailing Address |
Po Box 91734 Richmond VA 23291-1734 |
| Practice Telephone | 8048289350 |
| Practice Fax Number | 8048271744 |
| Mailing Telephone | 8043586100 |
| Mailing Fax Number | 8043427619 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2019-05-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
0101250349 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 417 N 11th St, Richmond, VA 232985002 | 8048289350 | 8048271744 |
| 1250 E Marshall St, Richmond, VA 232985051 | 8048289350 | 8048271744 |
| Street Address |
11958 W BROAD ST |
| City | HENRICO |
| State | VA |
| Zip Code | 23233-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962012542 | Kathryn May Gallanosa | Nurse Practitioner | 11958 W Broad St, Henrico, VA 23233-1007 | 2020-08-07 |
| 1780033050 | Virginia Commonwealth University Health System Authority | General Acute Care Hospital | 11958 W Broad St, Henrico, VA 23233-1007 | 2016-06-08 |
| 1174942700 | Jessica Hupe | Physical Medicine & Rehabilitation | 11958 W Broad St, Henrico, VA 23233 | 2014-04-10 |
| 1437431756 | Holly R Lake | Pharmacist | 11958 W Broad St, Henrico, VA 23233-1007 | 2011-09-13 |
| 1467748244 | Anish S. Patel | Internal Medicine | 11958 W Broad St, Henrico, VA 23233-1007 | 2011-06-21 |
| 1053607945 | Bradley Alan Stovall | Physical Medicine & Rehabilitation | 11958 W Broad St, Henrico, VA 23233-1007 | 2011-06-20 |
| 1801116371 | Jeremy A. Ross | Orthopaedic Surgery | 11958 W Broad St, Henrico, VA 23233 | 2010-06-08 |
| 1851525729 | Seema Kumar Patel | Internal Medicine | 11958 W Broad St, Henrico, VA 23233-1007 | 2009-05-07 |
| 1871755371 | Andrew Watson Chapman | Anesthesiology | 11958 W Broad St, Henrico, VA 23233-1007 | 2008-06-26 |
| 1326228222 | Scott Robert Haines | Psychiatry & Neurology | 11958 W Broad St, Henrico, VA 23233 | 2007-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813720 | David Rothman | Psychologist | 2000 Wilkes Drive, Richomd, VA 23233 | 2020-08-31 |
| 1770193286 | Penelope Kate Eissenberg | Occupational Therapist | Cedarfields, 2300 Cedarfield Parkway, Richmond, VA 23233 | 2020-08-10 |
| 1962038570 | Samantha Montgomery Warren | Nurse Practitioner | 3900 Westerre Parkway, Suite 300 Pmb# 308, Richmond, VA 23233 | 2020-03-15 |
| 1285269696 | Joyce Prayer Medical Transportion LLC | Transportation Broker | 2437 Bidgeview Ln, Henrico, VA 23233 | 2020-03-05 |
| 1821621228 | Marlon Reyes | Private Vehicle | 2500 Pump Rd, Richmond, VA 23233 | 2020-02-13 |
| 1659840924 | Brent Rusnak River Run Dental Greengate | Dentist | 3700 Haydenpark Lane, Medical Office J, Henrico, VA 23233 | 2018-11-16 |
| 1003309808 | Jeffrey Walker | Pharmacist | 3460 Pump Road, Henrico, VA 23233 | 2018-06-07 |
| 1346741667 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100, Richmond, VA 23233 | 2018-02-22 |
| 1215438544 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100a, Richmond, VA 23233 | 2018-02-22 |
| 1295235026 | Zackery Firesheets | Physical Therapy Assistant | 2422 University Park Blvd., Richmond, VA 23233 | 2018-02-19 |
| Find all providers in zip 23233 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326228222 | Scott Robert Haines | Psychiatry & Neurology | 11958 W Broad St, Henrico, VA 23233 | 2007-11-07 |
| 1982816757 | Matthew J. Barrett | Psychiatry & Neurology | 11958 W Broad St, Henrico, VA 23233-1007 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255975983 | Louise Rutledge | Psychiatry & Neurology | 1429 Buford Rd, N. Chesterfield, VA 23235 | 2019-11-06 |
| 1790342285 | Neural Network Pllc | Psychiatry & Neurology | 4660 Kenmore Ave Ste 408, Alexandria, VA 22304-1306 | 2019-05-21 |
| 1497226021 | Virginia Beach Neurology Ltd | Psychiatry & Neurology | 968 First Colonial Rd Ste 103, Virginia Beach, VA 23454-3171 | 2018-12-07 |
| 1750870556 | Evergreen Neurology and Sleep Center | Psychiatry & Neurology | 8609 Sudley Rd Ste 204, Manassas, VA 20110-4500 | 2018-05-07 |
| 1669976221 | Fairfax Family Life Behavioral Health, LLC | Psychiatry & Neurology | Fairfaxpark Office Plaza, 9512 B Lee Highway, Fairfax, VA 22031 | 2018-03-20 |
| 1821599234 | John H. Seok, M.d., P.C. | Psychiatry & Neurology | 3919 Old Lee Hwy Ste 81a, Fairfax, VA 22030-2430 | 2018-02-22 |
| 1326550989 | Acro Medical Group, LLC | Psychiatry & Neurology | 2106 Gallows Rd, Ste F, Vienna, VA 22182 | 2017-11-03 |
| 1023533718 | Riverside Physician Services Inc. | Psychiatry & Neurology | 659 Hospital Rd Ste 101, Tappahannock, VA 22560-7000 | 2017-08-03 |
| 1407306442 | Virginia Hospital Center Physician Group LLC | Psychiatry & Neurology | 1715 N George Mason Dr Ste 409, Arlington, VA 22205-3665 | 2016-10-13 |
| 1144676701 | Andrew Keith Worthington | Psychiatry & Neurology | 4200 Sulgrave Rd, Richmond, VA 23221-3255 | 2016-05-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KELLY G. GWATHMEY.
| 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.