KELLY STEVENS (NPI# 1104811959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104811959 |
| Entity Type | Individual |
| Full Name | KELLY STEVENS |
| Other Name | KELLY STEVENS-PICO |
| Credential | PA |
| Practice Address |
710 11th St N Columbus MT 59019-7215 |
| Practice Telephone | 4063221000 |
| Practice Fax Number | 4063225207 |
| Mailing Telephone | 4063221000 |
| Mailing Fax Number | 4063225207 |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2015-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 41208 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA3513 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 291575800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598308454 | Kelly Lynn Stevens | Nurse Practitioner | 11124 Wembley Landing Dr, Lithia, FL 33547-4945 | 2019-10-23 |
| 1407196868 | Kelly A Stevens | Licensed Practical Nurse | 42 Iroquois Ave, Lancaster, NY 14086-1706 | 2013-02-22 |
| 1861900458 | Kelly Lane Stevens | Marriage & Family Therapist | 13453 N Main St, Suite 104, Jacksonville, FL 32218 | 2018-01-17 |
| 1700397064 | Kelly Stevens | Physical Therapist | 2845 N Sheridan Rd, Suite 6400, Chicago, IL 60657 | 2017-10-13 |
| 1932645900 | Kelly Stevens | Occupational Therapist | 250 E Day Rd, Mishawaka, IN 46545-3471 | 2017-01-13 |
| 1649641978 | Kelly Lynn Stevens | Pharmacist | 2277 Iowa Ave, Independence, IA 50644-9106 | 2015-10-13 |
| 1427424522 | Kelly Stevens | Nurse Practitioner | 1141 S La Canada Dr, Green Valley, AZ 85614-1945 | 2015-08-12 |
| 1538546189 | Kelly L Stevens | Counselor | 106 Springview Ln, Summerville, SC 29485-8108 | 2015-05-04 |
| 1851417505 | Kelly A Stevens | Physician Assistant | 825 Eastlake Ave E, Seattle, WA 98109-4405 | 2007-03-22 |
| 1780700344 | Kelly Ann Stevens | Social Worker | 5505 Creedmoor Rd, Suite 100, Raleigh, NC 27612-6352 | 2007-03-22 |
| Street Address |
710 11TH ST N |
| City | COLUMBUS |
| State | MT |
| Zip Code | 59019-7215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447865910 | William Glenn Meredith | Occupational Therapist | 710 11th St N, Columbus, MT 59019-7215 | 2020-09-11 |
| 1508482076 | Kelcy Traeger | Occupational Therapist | 710 11th St N, Columbus, MT 59019-7215 | 2020-06-22 |
| 1417447590 | Lisa Marie Linday | Dietitian, Registered | 710 11th St N, Columbus, MT 59019-7215 | 2018-05-15 |
| 1366828782 | Valerie Maeker | Occupational Therapist | 710 11th St N, Columbus, MT 59019-7215 | 2015-08-07 |
| 1396799524 | Susan E Ivankovich | Physician Assistant | 710 11th St N, Columbus, MT 59019-7215 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376939892 | Marni Kay Ferster | Occupational Therapy Assistant | 350 West Pike Avenue, Columbus, MT 59019 | 2015-04-10 |
| 1477943611 | Josh Fisher | Pharmacist | 133 N 5th St, Columbus, MT 59019 | 2015-01-26 |
| 1669879102 | Chris Ann Mccann | Counselor | 612 E Pike Ave, Columbus, MT 59019 | 2014-11-27 |
| 1760722300 | Janell Marie Gibson | Midwife | 506 5th St N, Columbus, MT 59019 | 2013-02-19 |
| 1487893376 | Columbus Rural Fire Distric | Ambulance | 944 E Pike Ave., Columbus, MT 59019 | 2009-02-17 |
| 1598978165 | Michael Robert Matovich | Pharmacist | 133 N. 5th Street, Columbus, MT 59019 | 2007-05-08 |
| 1205978798 | Daniel Jeffery Vesbach | Dentist | 340 E. Pike Ave, Columbus, MT 59019 | 2007-02-13 |
| 1093852030 | Dale W Schlehuber | Dentist | 12 N. 4th St., Columbus, MT 59019 | 2007-01-31 |
| 1750439709 | Matovich Enterprises Inc | Durable Medical Equipment & Medical Supplies | 133 N 5th, Columbus, MT 59019 | 2007-01-08 |
| 1144313701 | Richard K. Klee | Family Medicine | 407 N. A, Columbus, MT 59019 | 2006-10-02 |
| Find all providers in zip 59019 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972960359 | Autumn Combs | Physician Assistant | 437 N Gould Rd Apt F, Columbus, OH 43209-1139 | 2016-01-15 |
| 1740665926 | Julianne Gonzalez | Physician Assistant | 350 Manchester Expy, Columbus, GA 31904-6435 | 2015-07-29 |
| 1629461165 | Michael Bryant | Physician Assistant | 911 Rudgate Rd, Columbus, GA 31904-2948 | 2015-03-09 |
| 1174880447 | Ricky Lee Martin Jr. | Physician Assistant | 2326 18th St Ste 210, Columbus, IN 47201-5362 | 2012-04-11 |
| 1710068374 | April K Howell | Physician Assistant | 2008 Wynnton Rd, Columbus, GA 31906-2407 | 2006-10-18 |
| 1124035399 | Diane L. Mitchell | Physician Assistant | 1130 Talbotton Rd, Columbus, GA 31904-8749 | 2006-08-01 |
| 1194752790 | Karen L Goodale | Physician Assistant | 2881 Nc Hwy 108 E, Columbus, NC 28722-7721 | 2006-06-27 |
| 1164469979 | Mark H Epps | Physician Assistant | 2000 10th Ave Ste 270, Columbus, GA 31901-3706 | 2006-06-01 |
| 1164484689 | Jim Lawrence Mcevers | Physician Assistant | 109 Shult Dr, Suite 101, Columbus, TX 78934-3015 | 2006-04-03 |
| 1972586287 | Susan A Farwell | Physician Assistant | 45 E Mills St, Columbus, NC 28722 | 2005-11-22 |
| Find all providers in COLUMBUS | ||||
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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.