KELLEY V JEFFERSON (NPI# 1154398105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154398105 |
| Entity Type | Individual |
| Full Name | KELLEY V JEFFERSON |
| Credential | MD |
| Practice Address |
1224 Trotwood Ave Columbia TN 38401-4802 |
| Mailing Address |
854 W James Campbell Blvd Suite 303 Columbia TN 38401-4659 |
| Practice Telephone | 9313804072 |
| Practice Fax Number | 9314907043 |
| Mailing Telephone | 9313804072 |
| Mailing Fax Number | 9314907043 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2010-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD37199 | TN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD37199 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1505466 | 05 | |
| TN | 3283015 | 05 | |
| TN | 3883064 | 05 | |
| TN | BCBST | 4192108 | 01 |
| Street Address |
1224 TROTWOOD AVE |
| City | COLUMBIA |
| State | TN |
| Zip Code | 38401-4802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316949191 | James Blair Butler | Radiology | 1224 Trotwood Ave, Southern Radiology Associates, Pllc, Columbia, TN 38401 | 2005-08-11 |
| 1063034791 | Kristen Nichole Miller | Physical Therapist | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2020-05-15 |
| 1487276358 | Jessie Marie Hipple | Pharmacist | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2020-05-13 |
| 1427684703 | Emily Robinson Mckamey | Registered Nurse | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2020-03-18 |
| 1013542711 | Robert Allen | Physical Therapist | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2020-03-03 |
| 1508408089 | Kacey Danette Rice | Registered Nurse | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2019-10-16 |
| 1144862400 | Trisha Marie Van Wyk | Dietitian, Registered | 1224 Trotwood Ave, Columbia, TN 38401 | 2019-10-08 |
| 1518522309 | Courtney Brooke Hollis | Nurse Practitioner | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2019-05-07 |
| 1871070839 | Leah Shrader | Dietitian, Registered | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2018-07-23 |
| 1932695772 | Hannah Elizabeth Boren | Pharmacist | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2018-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327629 | Andrew Swensen | Pharmacist | 1202 South James Campbell Blvd, Columbia, TN 38401 | 2020-08-17 |
| 1790305522 | Milaya L Webster | Community Based Residential Treatment Facility, Mental Illness | 809 South Water Streer, Columbia, TN 38401 | 2020-04-22 |
| 1730729468 | Dania Cortez | Licensed Practical Nurse | 40 Park Plus Court, Columbia, TN 38401 | 2020-01-10 |
| 1619519683 | Agilitas Usa, Inc | Clinic/Center | 627 S. James Campbell Blvd., Suite B, Columbia, TN 38401 | 2019-10-11 |
| 1710531280 | Abby Graves | Dietitian, Registered | 1216 Trottwood Ave, Columbia, TN 38401 | 2019-08-01 |
| 1942771746 | James Brian Gregory | Marriage & Family Therapist | 497 E James Campbell Blvd, Columbia, TN 38401 | 2018-12-06 |
| 1104312255 | Sarah Miller | Social Worker | 230 E James Campbell Boulevard, Suite 113, Columbia, TN 38401 | 2018-07-02 |
| 1407343148 | Tammy Lynn James | Nurse Practitioner | 6011 Trotwood Ave Ste D, Columbia, TN 38401 | 2018-04-18 |
| 1053838276 | Tiffany Huskey | Audiologist-Hearing Aid Fitter | 1202 S James Campbell Blvd, Suite 15, Columbia, TN 38401 | 2017-08-28 |
| 1942726963 | Northland Hearing Center, Inc. | Hearing Aid Equipment | 1202 South James Campbell Blvd, Suite 15, Columbia, TN 38401 | 2017-08-22 |
| Find all providers in zip 38401 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808815 | Thai Quoc Nguyen | Internal Medicine | University Hospital Ma421 Med Sciences Bldg, Columbia, MO 65212-0001 | 2020-07-06 |
| 1649898784 | Peter Egwom | Internal Medicine | University Hospital One Hospital Drive Dc.043.00, Columbia, MO 65212-0001 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1851918346 | Maxwell Isaac | Internal Medicine | University Hospital 1 Hospital Drive Dc 043.00, Columbia, MO 65212-0001 | 2020-06-30 |
| 1285251983 | Shannon Ejiofor | Internal Medicine | University Hospital One Hospital Drive Dc043.00, Columbia, MO 65212-0001 | 2020-06-29 |
| 1336766278 | Jordan Stauffer | Internal Medicine | University Hospital One Hospital Dr, Columbia, MO 65212-0001 | 2020-06-26 |
| 1972120814 | Pak Ho Au | Internal Medicine | University Hospital One Hospital Dr Dc043.00, Columbia, MO 65212-0001 | 2020-06-26 |
| 1700402849 | Michael Allan Goble | Internal Medicine | Internal Medical Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-24 |
| 1740806389 | Alan Verl Godfrey | Internal Medicine | University of Missouri Hospital 1 Hospital Dr, Columbia, MO 65212-0001 | 2020-06-19 |
| 1003432642 | Gregory Gaskey | Internal Medicine | University of Missouri Hospital One Hospital Drive, Columbia, MO 65212-0001 | 2020-06-19 |
| Find all providers in COLUMBIA | ||||
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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.