DR. KELLY DEAN SKANCHY (NPI# 1154313971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154313971 |
| Entity Type | Individual |
| Full Name | DR. KELLY DEAN SKANCHY |
| Credential | M.D. |
| Practice Address |
2450 Craven St Bldg 3300 Naval Health Clinic Naval Station San Diego San Diego CA 92136-5599 |
| Mailing Address |
2450 Craven St Bldg 3300 Naval Health Clinic Naval Base San Diego San Diego CA 92136-5599 |
| Practice Telephone | 6195565936 |
| Practice Fax Number | 6195569419 |
| Mailing Telephone | 6195565936 |
| Mailing Fax Number | 6195569419 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2014-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
GFE83510 | CA | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
MD044935L | PA | Allopathic & Osteopathic Physicians |
| Street Address |
2450 CRAVEN ST BLDG 3300 NAVAL HEALTH CLINIC NAVAL STATION SAN DIEGO |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92136-5599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497220792 | Anthony Banaag | Specialist/Technologist | 2450 Craven St Bldg 3300, San Diego, CA 92136-5599 | 2018-10-12 |
| 1194239616 | Deborah Perez | Specialist/Technologist | 2450 Craven St Bldg 3300, San Diego, CA 92136-0001 | 2017-11-20 |
| 1336533306 | German Cea | Student in an Organized Health Care Education/Training Program | 2450 Craven St Bldg 3300, San Diego, CA 92136-5599 | 2015-03-26 |
| 1043571854 | Brian Eugene Mckinney | General Practice | 2450 Craven St Bldg 3300, San Diego, CA 92136-5599 | 2012-06-07 |
| 1447305172 | Jeffrey Lloyd Lester | Family Medicine | 2450 Craven St Bldg 3300, San Diego, CA 92136-5599 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467930164 | Alexa Clifton | Student in an Organized Health Care Education/Training Program | 2525 Callagan Hwy, Fpo, AA 92136 | 2018-08-03 |
| 1235501321 | Family Optometric Associates of California, Inc. | Optometrist | 2260 Callahan Hwy, Bldg 3187-a, San Diego, CA 92136 | 2015-10-28 |
| 1457720427 | Andres Bargados Santamaria IIi | Military Health Care Provider | 116 Cummings Rd, San Diego, CA 92136 | 2015-09-21 |
| 1932470374 | Robert Bishop Beedles Jr. | Military Health Care Provider | 3380 Sturtevant St, Bldg 57 Second Floor, San Diego, CA 92136 | 2012-01-17 |
| 1083771877 | Brianna Leigh Rupp | General Practice | Uss Tarawa Lha 1 Fpo Ap 96622-1600, San Diego, CA 92136 | 2007-01-02 |
| 1396814836 | Alberia Joseph Davis | Military Health Care Provider | Pcd Sampson (ddg-102), 3975 Norman Scott Rd, San Diego, CA 92136 | 2006-11-07 |
| 1831275866 | Roslyn Jones Jackson | Nurse Practitioner | 2450 Craven Streeet, San Diego, CA 92136 | 2006-10-31 |
| 1699743534 | Mark L Williamson | Military Health Care Provider | 3325 Senn Road, Comdesron One Building 55 Second Floor, San Diego, CA 92136 | 2006-03-08 |
| 1467423335 | John M. Hintz | Psychologist | Branch Medical Clinic, Naval Station, San Diego, CA 92136 | 2006-01-30 |
| 1659341089 | Kenichi Carrigan | Preventive Medicine | 3235 Albacore Alley, San Diego, CA 92136 | 2006-01-26 |
| Find all providers in zip 92136 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699015529 | Andrew Saleh | Family Medicine | 1370 Rosecrans St Ste A, San Diego, CA 92106-2676 | 2013-03-01 |
| 1487913588 | James Toldi | Family Medicine | 4010 Sorrento Valley Blvd Ste 300, San Diego, CA 92121-1433 | 2012-05-09 |
| 1881798221 | Frederick Allen Richburg II | Family Medicine | 4010 Sorrento Valley Blvd, Suite 300, San Diego, CA 92121-1432 | 2006-09-07 |
| 1346351665 | Stephen M Daquino | Family Medicine | 16445 Bernardo Center Dr, San Diego, CA 92128-2523 | 2006-08-31 |
| 1093821639 | Robert Arnold Baker | Family Medicine | 1820 Washington Pl, San Diego, CA 92103-2723 | 2006-08-23 |
| 1437172533 | Kenneth L. Anderson IIi | Family Medicine | 1945 Garnet Ave, San Diego, CA 92109-3595 | 2006-07-26 |
| 1417936295 | Joseph Lee Moore | Family Medicine | 975 Garnet Ave, San Diego, CA 92109-2729 | 2006-01-11 |
| 1376106849 | Joseph E Allen Md Inc | Family Medicine | 4116 W Point Loma Blvd, San Diego, CA 92110-5605 | 2019-04-19 |
| 1215382841 | Alex Bernadett | Family Medicine | 4010 Sorrento Valley Blvd Ste 300, San Diego, CA 92121-1433 | 2016-05-02 |
| 1770966988 | Samuel Galloway | Family Medicine | 9909 Mira Mesa Blvd Ste 200, San Diego, CA 92131-1061 | 2015-07-07 |
| Find all providers in SAN DIEGO | ||||
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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.