KELLY JO MCDERMOTT (NPI# 1114386794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114386794 |
| Entity Type | Individual |
| Full Name | KELLY JO MCDERMOTT |
| Other Name | KELLY JO KRETCHMER |
| Practice Address |
525 N Foster St Mitchell SD 57301-2966 |
| Practice Telephone | 6059955701 |
| Practice Fax Number | 6059955700 |
| Mailing Telephone | 6059955701 |
| Mailing Fax Number | 6059955700 |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CP001027 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962684712 | Kelly Mckenna Mcdermott | Speech-Language Pathologist | 345 E Juniper St, Mesa, AZ 85201-1825 | 2007-12-04 |
| 1104946011 | Kelly Therese Mcdermott | Midwife | 527 Western Ave, Albany, NY 12203-1746 | 2007-04-02 |
| 1124183330 | Kelly Hartnett Mcdermott | Dentist | 111 Gaslight Blvd, Suite A, Lufkin, TX 75904-3188 | 2006-12-27 |
| 1619593258 | Kelly Eileen Mcdermott | Internal Medicine | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-06-19 |
| 1972818458 | Kelly Renee Mcdermott | Physical Therapist | 15 Parkman St, Room 128, Boston, MA 02114-3117 | 2010-08-09 |
| 1639216757 | Kelly M Mcdermott | Home Health | 111 S Bedford St, Burlington, MA 01803-5145 | 2007-01-30 |
| 1720006877 | Kelly Mcdermott | Nurse Anesthetist, Certified Registered | 800 Spruce St, Philadelphia, PA 19107-6130 | 2006-07-17 |
| Street Address |
525 N FOSTER ST |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-2966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324507 | Avera Queen of Peace | Emergency Medicine | 525 N Foster St, Mitchell, SD 57301-2966 | 2005-05-31 |
| 1831752393 | Avera Queen of Peace | Preventive Medicine | 525 N Foster St, Mitchell, SD 57301-2966 | 2019-04-19 |
| 1609358035 | Rachel Dykstra | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-09-01 |
| 1598241820 | Sarah Lynne Bauer | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-07-19 |
| 1053827634 | Avera Queen of Peace | Radiology | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-19 |
| 1821504515 | Mollie Jo Loes | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-18 |
| 1669987137 | Karen Faye Klinkner | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-06 |
| 1295240786 | Katherine Caroline Thomsen | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-06 |
| 1205359031 | Avera Queen of Peace | Hospitalist | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-07-24 |
| 1669822946 | Jenna Bortnem | Physical Therapist | 525 N Foster St, Mitchell, SD 57301-2966 | 2016-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721388 | Dakota Counseling Institute | Social Worker | 910 W Havens, Mitchell, SD 57301 | 2020-05-08 |
| 1215588512 | Carolyn Marie Klinkhammer | Registered Nurse | 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 | 2019-09-27 |
| 1720596893 | Brian Bannwarth | Pharmacist | 25147 Campground Road, Mitchell, SD 57301 | 2018-01-11 |
| 1336664135 | Haley Long | Speech-Language Pathologist | 200 East Havens, Mitchell, SD 57301 | 2017-08-14 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1467831685 | Amanda Louise Johnson | Physical Therapist | 910 S Edgerton, Mitchell, SD 57301 | 2015-05-20 |
| 1922432830 | Melissa Jill Maier | Dentist | 240 E 23 Ave, Mitchell, SD 57301 | 2013-08-27 |
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1184945958 | Kimberly L Lienemann | Counselor | 403 N Lawler St, Mitchell, SD 57301 | 2010-06-16 |
| 1134365554 | Gronsten-maier Dental Prof. LLC | Dentist | 240 E. 23rd Avenue, Mitchell, SD 57301 | 2009-01-07 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285038265 | Jessica Lea Preheim | Nurse Practitioner | 204 W Havens Ave, Mitchell, SD 57301-3906 | 2014-10-20 |
| 1407902968 | Cindy Kay Mulder | Nurse Practitioner | 909 South Miller, Mitchell Family Planning, Mitchell, SD 57301 | 2007-01-26 |
| 1154896801 | Angela Mae Broughton | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2018-10-09 |
| 1609358035 | Rachel Dykstra | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-09-01 |
| 1417495649 | Laura Axsom | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2017-02-08 |
| 1780055780 | Lacey Bonte | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2015-10-15 |
| 1558614461 | Brian Dean Brazzell | Nurse Practitioner | 105 Teke Burton Dr, Mitchell, IN 47446-1208 | 2012-10-17 |
| 1083991012 | Heidi M Gehrke | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2966 | 2011-11-04 |
| 1811225717 | Kristi Jo Nissley | Nurse Practitioner | 2759 State Road 37, Mitchell, IN 47446 | 2009-12-03 |
| 1780865626 | Betsy M Van Genderen | Nurse Practitioner | 2100 Highland Way Ste K, Mitchell, SD 57301-6409 | 2007-11-20 |
| Find all providers in MITCHELL | ||||
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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.