KELLY A JOHNSON (NPI# 1144539107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144539107 |
| Entity Type | Individual |
| Full Name | KELLY A JOHNSON |
| Other Name | KELLY A LARGE |
| Credential | NP |
| Practice Address |
2 Great Falls Plz Ste 21 Auburn ME 04210-5966 |
| Mailing Address |
Po Box 7291 Lewiston ME 04243-7291 |
| Practice Telephone | 2073303950 |
| Practice Fax Number | 2073303955 |
| Mailing Telephone | 2077778950 |
| Mailing Fax Number | 2077778800 |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2019-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP101067 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 583 Lisbon St, Lisbon Falls, ME 042521250 | 2073538830 | 2073534836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023631249 | Kelly Lynn Johnson | Occupational Therapist | 22123 Figueroa St Unit 113, Carson, CA 90745-4464 | 2020-05-21 |
| 1851932404 | Kelly Christine Johnson | Nurse Practitioner | 7319 Stonerock Cir # 106, Orlando, FL 32819-8002 | 2019-10-04 |
| 1083274989 | Kelly Danielle Johnson | Registered Nurse | 76 Dubois Ct Apt D, Englewood, NJ 07631-3439 | 2019-06-13 |
| 1871151365 | Kelly Johnson | Family Medicine | 103 S White Oak Rd, White Oak, TX 75693-1517 | 2019-05-30 |
| 1194288753 | Kelly Mills Johnson | Psychologist | 100 Bush St Ste 918, San Francisco, CA 94104-3950 | 2019-04-10 |
| 1700345345 | Kelly Marlene Johnson | Nurse Practitioner | 1320 E Oklahoma Ave, Guthrie, OK 73044-3757 | 2019-03-13 |
| 1891253597 | Kelly Marie Johnson | Specialist/Technologist | 1472 Mobley Ct, Frederick, MD 21701-9113 | 2019-03-12 |
| 1447744347 | Kelly Theresa Johnson | Speech-Language Pathologist | 5272 River Rd Ste 100, Bethesda, MD 20816-1454 | 2018-06-14 |
| 1962902882 | Kelly M Johnson | Licensed Vocational Nurse | 118 Brazos Ln, Kyle, TX 78640-5289 | 2018-02-16 |
| 1427573476 | Kelly Colleen Johnson | Social Worker | 2530 Meridian Parkway, Suite 300, Pbn: 3071, Durham, NC 27713-2771 | 2017-08-11 |
| Street Address |
2 GREAT FALLS PLZ STE 21 |
| City | AUBURN |
| State | ME |
| Zip Code | 04210-5966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629074240 | Edwin V Tan | Internal Medicine | 2 Great Falls Plz Ste 21, Auburn, ME 04210 | 2005-06-28 |
| 1902336340 | Diana Trofimovitch | Internal Medicine | 2 Great Falls Plz Ste 21, Auburn, ME 04210-5966 | 2017-06-18 |
| 1861920746 | Hoang V Dang | Family Medicine | 2 Great Falls Plz Ste 21, Auburn, ME 04210-5966 | 2017-05-23 |
| 1487181046 | James R. Ozon | Internal Medicine | 2 Great Falls Plz Ste 21, Auburn, ME 04210-5966 | 2017-05-15 |
| 1811208887 | Garrett F. Smith | Physician Assistant | 2 Great Falls Plz Ste 21, Auburn, ME 04210-5966 | 2010-06-24 |
| 1417147331 | Amy L.r. Dudley | Family Medicine | 2 Great Falls Plz Ste 21, Auburn, ME 04210 | 2007-07-26 |
| 1730285982 | Lisa Jean Boucher | Physician Assistant | 2 Great Falls Plz Ste 21, Auburn, ME 04210-5966 | 2006-09-15 |
| 1780799437 | Heidi M Larson | Family Medicine | 2 Great Falls Plz Ste 21, Auburn, ME 04210-5966 | 2006-08-21 |
| 1205802212 | John M Woytowicz | Family Medicine | 2 Great Falls Plz Ste 21, Auburn, ME 04210-5966 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538632245 | Matthew Charles Dove | Specialist/Technologist | 30 Belgrade Ave, Suite A, Auburn, ME 04210 | 2019-01-04 |
| 1851880603 | Dba Central Maine Conditioning Clinic | Massage Therapist | 30 Belgrade Ave Suite A, Auburn, ME 04210 | 2018-05-08 |
| 1285189654 | Kimberly Ann Boutwell | Nurse Practitioner | 15 Gracelawn Road, Auburn, ME 04210 | 2016-08-16 |
| 1487036554 | Eric Morrow | Specialist/Technologist | 36 Belgrade Ave, Auburn, ME 04210 | 2015-06-24 |
| 1750770152 | Larissa J Brown | Marriage & Family Therapist | 86 Main Sreet, Suite 302, Auburn, ME 04210 | 2015-01-22 |
| 1659771046 | Daniel Fontaine | Pharmacist | 689 Minot Ave., Auburn, ME 04210 | 2014-09-04 |
| 1104236793 | Caitlin White | Occupational Therapist | 415 Rodman Road, Auburn, ME 04210 | 2014-05-05 |
| 1780954883 | Richard Marc Pelletier | Counselor | 24 Dunn Street, Auburn, ME 04210 | 2012-01-05 |
| 1285929026 | Cynthia Morgan | Social Worker | 60 Court St., Auburn, ME 04210 | 2011-06-09 |
| 1972811164 | Wendy Thomas-blais | Social Worker | 229 Center St 2, Auburn, ME 04210 | 2010-09-22 |
| Find all providers in zip 04210 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935658 | Judith A Glover | Nurse Practitioner | 1101 Rock Elm Dr, Auburn, GA 30011-2393 | 2020-09-02 |
| 1568075190 | Carey Webster | Nurse Practitioner | 11775 Education St Ste 210, Auburn, CA 95602-2453 | 2020-08-24 |
| 1043860299 | Kimberly Danner | Nurse Practitioner | 507 Red Bud Ln, Auburn, IL 62615-9357 | 2019-09-18 |
| 1467001214 | Lauren Elizabeth Sabo | Nurse Practitioner | 906 W North St, Auburn, IL 62615-1046 | 2019-09-04 |
| 1952876294 | Modeline Jules | Nurse Practitioner | 125 3rd St Ne Ste 403, Auburn, WA 98002 | 2018-10-12 |
| 1063987162 | Shadiyah S Tawwab | Nurse Practitioner | 1702 Catherine Ct Ste 1a, Auburn, AL 36830-5790 | 2018-10-04 |
| 1801370812 | Catherine Molly Kohl | Nurse Practitioner | 1702 Catherine Ct Ste A, Auburn, AL 36830-5755 | 2018-09-17 |
| 1518443258 | Kelly Elizabeth Cordon | Nurse Practitioner | 77 Nelson St Fl 3, Auburn, NY 13021-1944 | 2018-07-16 |
| 1750873329 | Claire Wakulyaka | Nurse Practitioner | 39 Bryn Mawr Ave, Auburn, MA 01501-1636 | 2018-05-30 |
| 1467963710 | Alissa Marie Dippolito | Nurse Practitioner | 77 Nelson St Ste 310, Auburn, NY 13021-1945 | 2017-10-13 |
| Find all providers in AUBURN | ||||
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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.