DR. KELLY ANNE WALSH (NPI# 1114191699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114191699 |
| Entity Type | Individual |
| Full Name | DR. KELLY ANNE WALSH |
| Credential | DO |
| Practice Address |
28 Jackson Ave Pompton Plains NJ 07444-1479 |
| Mailing Address |
Po Box 416457 Boston MA 02241-6457 |
| Practice Telephone | 9738352575 |
| Practice Fax Number | 9738350531 |
| Mailing Telephone | 8443621735 |
| Mailing Fax Number | 9732907495 |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25MB07796700 | NJ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649810136 | Kelly Alaina Walsh | Student in an Organized Health Care Education/Training Program | 289 Elm St Apt 62c, Medford, MA 02155-1068 | 2020-01-13 |
| 1518210210 | Kelly L Walsh | Speech-Language Pathologist | 4810 Ivy Ridge Dr Se, Unit 306, Smyrna, GA 30080-6660 | 2012-10-18 |
| 1902838675 | Kelly Walsh | Social Worker | 8479 S. Mason Montgomery Road, Suite 4, Mason, OH 45040-4023 | 2006-07-06 |
| 1063056802 | Kelly Walsh | Social Worker | 120 Chestnut St, Ridgewood, NJ 07450-2504 | 2019-11-05 |
| 1427692557 | Kelly Elizabeth Walsh | Recreation Therapist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2019-10-31 |
| 1225686934 | Kelly Walsh | Counselor | 115 Keating Dr, Belle Chasse, LA 70037-1629 | 2019-08-27 |
| 1790266195 | Kelly A Walsh | Occupational Therapist | 13900 Ne 3rd Ct, Miami, FL 33161-2834 | 2018-08-23 |
| 1013434927 | Kelly Ann Walsh | Nurse Practitioner | 317 E 34th St, New York, NY 10016-4974 | 2017-08-23 |
| 1790227858 | Kelly Walsh | Physical Therapist | 4201 Lake Boone Trl, Suite 4, Raleigh, NC 27607-7512 | 2016-11-07 |
| 1265989909 | Kelly Walsh | Registered Nurse | 24200 Chagrin Blvd, Beachwood, OH 44122 | 2016-09-09 |
| Street Address |
28 JACKSON AVE |
| City | POMPTON PLAINS |
| State | NJ |
| Zip Code | 07444-1479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790778405 | Jeffrey Steven Dobro | Internal Medicine | 28 Jackson Ave, Pompton Plains, NJ 07444-1453 | 2005-08-26 |
| 1164072856 | Meredith Blitz, Dds, LLC | Dentist | 28 Jackson Ave, Pompton Plains, NJ 07444-1479 | 2019-09-16 |
| 1982928313 | Louis C Gubitosa and Vincent M Frey Dmd LLC | Dentist | 28 Jackson Ave, Pompton Plains, NJ 07444-1479 | 2010-03-14 |
| 1497809602 | Vincent Martin Frey | Dentist | 28 Jackson Ave, Pompton Plains, NJ 07444 | 2007-01-23 |
| 1710031968 | Louis Carmen Gubitosa | Dentist | 28 Jackson Ave, Pompton Plains, NJ 07444 | 2007-01-23 |
| 1588730667 | Dana Lyn S. Brahms | Internal Medicine | 28 Jackson Ave, Pompton Plains, NJ 07444-1479 | 2006-11-28 |
| 1356321780 | Michael R. Dara | Internal Medicine | 28 Jackson Ave, Pompton Plains, NJ 07444-1453 | 2006-01-20 |
| 1851371835 | Tracy Smith-dipalo | Internal Medicine | 28 Jackson Ave, Pompton Plains, NJ 07444-1453 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407383144 | Kaitlin Vanderhoff | Social Worker | 193 Mountain Avenue, Pompton Plains, NJ 07444 | 2017-05-12 |
| 1285026872 | Mckeever Dental Care | Dentist | 933 Rt 23, Pompton Plains, NJ 07444 | 2015-02-19 |
| 1164609277 | Mary Milbank Bodenstein | Social Worker | 640 Newark Pompton Turnpike, Pompton Plains, NJ 07444 | 2008-01-31 |
| 1548470115 | Roger R. Hancox | Counselor | 142 Route 23 North, Pompton Plains, NJ 07444 | 2007-05-23 |
| 1215147772 | Joanne Roach Stickles | Counselor | 933 Route 23 South, Suite 10, Pompton Plains, NJ 07444 | 2007-05-23 |
| 1366584583 | Gleb Koslov | Chiropractor | 933 Route 23, Pequannock, NJ 07444 | 2007-02-13 |
| 1730245556 | Ykr Orthopedics | Specialist | 901 State Route 23 South, Floor 2, Pompton Plains, NJ 07444 | 2006-12-28 |
| 1548328362 | Violeta Trajkovska | Optometrist | 500 Rt 23 North, Pompton Plains, NJ 07444 | 2006-12-05 |
| 1245308097 | L Michelle Borden | Social Worker | 21 Evans Place, Pompton Plains, NJ 07444 | 2006-12-01 |
| 1952487837 | John Liaci Sr. | Chiropractor | 381 Route 23 South, Pompton Plains, NJ 07444 | 2006-10-31 |
| Find all providers in zip 07444 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720369101 | Donald W Rumbaugh | Family Medicine | 620 Rte 23, Pompton Plains, NJ 07444-1468 | 2011-08-30 |
| 1942439625 | Simarjit Singh | Family Medicine | 620 State Rt 23, Pompton Plains, NJ 07444-1468 | 2009-07-02 |
| 1154517266 | Paul A. Ostergaard Mdpc | Family Medicine | 679 Turnpike Tpke, Pompton Plains, NJ 07444-1327 | 2007-09-21 |
| 1962504753 | Paul A Ostergaard | Family Medicine | 679 Turnpike, Pompton Plains, NJ 07444 | 2006-09-02 |
| 1356383863 | Mario R Capio | Family Medicine | 230 W Parkway, Unit 10, Pompton Plains, NJ 07444-1060 | 2006-06-11 |
| 1548672249 | Chelsea Brower | Family Medicine | 1 Cedar Crest Dr, Pompton Plains, NJ 07444 | 2014-05-29 |
| 1760659379 | Senior Campus Primary Care Physicians PC | Family Medicine | 1 Cedar Crest Dr, Pompton Plains, NJ 07444-2100 | 2008-05-13 |
| 1972710283 | Charles William Ross | Family Medicine | 97 W Parkway, Pompton Plains, NJ 07444-1647 | 2007-05-17 |
| 1992725832 | Erickson Health Medical Group of New Jersey PC | Family Medicine | 1 Cedar Crest Village Dr, Pompton Plains, NJ 07444-2100 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234609 | Universal Management Group Inc. | Family Medicine | 611 Albert Pl, Ridgewood, NJ 07450-5308 | 2020-10-26 |
| 1962009381 | Savannah Haririe | Family Medicine | 9 N Dorado Dr, Morristown, NJ 07960 | 2020-10-08 |
| 1023615168 | Well Health Medical Practice | Family Medicine | 676 Amboy Ave Ste 4, Woodbridge, NJ 07095-3144 | 2020-10-01 |
| 1538776380 | Reusik | Family Medicine | 302 Brookmead Dr, Cherry Hill, NJ 08034-2729 | 2020-09-25 |
| 1265048359 | Seungyeon Lee | Family Medicine | 4609 Quail Ridge Dr, Plainsboro, NJ 08536-4232 | 2020-09-23 |
| 1558976670 | Nyc Regenerative Medicine Inc. | Family Medicine | 315 Route 34 Ste 103, Colts Neck, NJ 07722-2444 | 2020-09-15 |
| 1831700715 | Tree of Life Integrative Family Medicine | Family Medicine | 1200 Little Gloucester Rd Apt 1315, Clementon, NJ 08021-5874 | 2020-08-13 |
| 1972127629 | Alysha Marengo | Family Medicine | 326 Pine St, Pompton Lakes, NJ 07442-1617 | 2020-05-28 |
| 1790308583 | Iz Medical LLC | Family Medicine | 250 Moonachie Rd, Moonachie, NJ 07074-1378 | 2020-05-27 |
| 1629691241 | Wayne R Schneider,m.d.,llc | Family Medicine | 56 Tuckahoe Rd, Marmora, NJ 08223-1206 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | POMPTON PLAINS |
| Zip Code | 07444 |
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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.