JACQUELINE KELLY


Address: 500 West Fort St. #111, Boise Vamc, Boise, ID 83702
Phone: 2084221314

JACQUELINE KELLY (NPI# 1104169283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104169283
Entity Type Individual
Full Name JACQUELINE KELLY
Credential M.D.
Practice Address 500 West Fort St. #111
Boise Vamc
Boise
ID 83702
Practice Telephone 2084221314
Enumeration Date 2013-03-27
Last Update Date 2013-07-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine MRM-1350 ID Allopathic & Osteopathic Physicians

Other Providers JACQUELINE KELLY

NPI Name Taxonomy Address Enumeration
1669432498 Jacqueline F Kelly Legal Medicine 1428 S Osprey Ave, Sarasota, FL 34239-2914 2006-03-24
1699774505 Jacqueline Kelly General Practice 300 E 8th St, G-159, Austin, TX 78701-3233 2005-07-21
1558855296 Jacqueline Kelly Nurse Practitioner 1638 Owen Dr, Fayetteville, NC 28304-3424 2018-06-17
1730507971 Jacqueline Kelly Radiology 20 York St, Ynhh Department of Therapeutic Radiology, New Haven, CT 06510-3220 2014-04-04
1710293436 Jacqueline Kelly Marriage & Family Therapist 220 George W Liles Pkwy Nw, Concord, NC 28027-6531 2010-08-19
1124109624 Jacqueline Kelly Nurse Practitioner 400 Gresham Dr, Suite 303, Norfolk, VA 23507-1901 2006-10-18
1235231630 Jacqueline Kelly Pediatrics 269 Peninsula Farm Rd, Suite F, Arnold, MD 21012-1013 2006-09-05

Office Location

Street Address 500 WEST FORT ST. #111
BOISE VAMC
City BOISE
State ID
Zip Code 83702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164832374 Diana Swett Student in an Organized Health Care Education/Training Program 500 West Fort St. #111, Boise Vamc, Boise, ID 83702 2014-04-28

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790321966 Inland Northwest Neuromonitoring Pllc Psychiatry & Neurology 950 Bannock Street, Suite 1100, Boise, ID 83702 2019-11-22
1508359084 Emily Cook Dietitian, Registered St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 2018-06-11
1265925887 Marla Braendle Dietitian, Registered St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 2018-06-08
1114419678 Sidrah Khan Psychotherapy PC Social Worker 242 N 8th St, Suite 200, Boise, ID 83702 2018-05-31
1508386707 Emp Idaho Nampa, LLC General Acute Care Hospital 350 E Myrtle Street, Suite 100, Boise, ID 83702 2017-06-20
1194264077 Karen Mangum Dietitian, Registered 115 N. Main Street, Suite #203, Boise, ID 83702 2017-02-13
1750828422 Stephen Pyper Massage Therapist 14089 Main St #100, Boise, ID 83702 2017-01-19
1427504398 The Young Mens Christian Association of Boise City Idaho Health Educator 419 N 11th St, Boise, ID 83702 2016-08-30
1942756838 Brent Hiroshi Sasaki Pharmacist 500 West Fort Street (119), Boise, ID 83702 2016-08-30
1578912051 Marnae Walker Counselor 509 S. 14th St, Suite 2, Boise, ID 83702 2016-06-06
Find all providers in zip 83702

Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891256004 Ryan Thompson Internal Medicine 400 W Fort St # 111r, Boise, ID 83702-4531 2019-03-29
1518311679 Samantha Hersrud Internal Medicine 500 W Fort St 111r, Internal Medicine Residency, Boise, ID 83702 2016-04-14
1649634718 Elizabeth Ann Schackmann Internal Medicine 500 W Fort St # 111r, Boise, ID 83702-4501 2016-04-05
1134513088 Alex Tanabe Internal Medicine 1000 E Park Blvd, Boise, ID 83712-7791 2015-03-27
1083980734 Shanaz Sikder Internal Medicine 403 S 11th St Ste 100, Boise, ID 83702 2012-03-27
1679869473 Allyson J Komori Internal Medicine 500 W Fort St # 111, Suite 202, Boise, ID 83702-4501 2011-06-21
1982929048 Sarita Anisha Kishore Internal Medicine 1970 Toluka Way, Boise, ID 83712-8547 2010-04-01
1568796282 Life Quest Center Inc Internal Medicine 3355 N Five Mile Rd, Ste 284, Boise, ID 83713-3925 2009-09-28
1164673968 Jenifer L Barry Internal Medicine 1525 S Owyhee St, Boise, ID 83705-6014 2008-10-10
1275722704 Allan M Salzberg Internal Medicine 10671 Sandpiper St, Boise, ID 83709-1249 2007-10-22
Find all providers in BOISE

Competitor

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City BOISE
Zip Code 83702

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Dataset Information

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.

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