DR. STEVEN ELLSWORTH KELLY (NPI# 1154809002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154809002 |
| Entity Type | Individual |
| Full Name | DR. STEVEN ELLSWORTH KELLY |
| Credential | MD |
| Practice Address |
5169 S Cottonwood St Ste 303 Murray UT 84107-6768 |
| Mailing Address |
1225 W 1000 S Apt D408 Orem UT 84058-4127 |
| Practice Telephone | 8015073750 |
| Mailing Telephone | 2082064073 |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881231850 | Steven Kelly | Case Management | 3500 Carnegie Ave., Cleveland, OH 44115 | 2019-12-09 |
| 1932330693 | Steven Kelly | Social Worker | 151 S University Ave # 1400, Provo, UT 84601-4427 | 2009-07-29 |
| 1841753811 | Steven Joseph Kelly | Student in an Organized Health Care Education/Training Program | 100 Madison Ave, Morristown, NJ 07960-6136 | 2019-04-08 |
| 1548780588 | Steven Kelly | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2017-06-21 |
| 1649613860 | Steven Randall Kelly | Counselor | 8215 Westchester Dr, 240, Dallas, TX 75225-6103 | 2013-04-08 |
| 1528376506 | Steven James Kelly | Counselor | 147 S River St, Suite 204, Santa Cruz, CA 95060-4551 | 2010-09-23 |
| 1841348240 | Steven Michael Kelly | Otolaryngology | 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010-7667 | 2007-01-08 |
| 1821178377 | Steven Michael Kelly | Dentist | 322 Dental Science Bldg S, Iowa City, IA 52242-1001 | 2006-10-17 |
| 1831289149 | Steven Robert Kelly | Anesthesiology | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2006-10-15 |
| 1629086475 | Steven Mark Kelly | Surgery | 2600 6th St Sw, Aultman Hospital, Canton, OH 44710-1702 | 2006-08-04 |
| Street Address |
5169 S COTTONWOOD ST STE 303 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-6768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871045690 | Alex Coffman | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2016-10-27 |
| 1194354621 | Ali Syed Ahmed | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2020-04-06 |
| 1699303693 | Kimberly Nolan | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2020-03-27 |
| 1366079493 | Christian Smith | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2020-03-26 |
| 1104453273 | Spencer Taylor Pickett | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2020-03-26 |
| 1508427469 | David Charles Gage | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2019-06-21 |
| 1851854574 | Treg Corbridge | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2019-04-09 |
| 1609337682 | Braden Jenkins | Podiatrist | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2019-03-30 |
| 1295221869 | Christopher Kiser | Podiatrist | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2018-07-07 |
| 1053801324 | Jordan James Radandt | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2018-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1396354585 | Esmeralda Ruby Barron | Student in an Organized Health Care Education/Training Program | 1344 E Merritt Cir, Murray, UT 84117-7327 | 2020-07-24 |
| 1669097705 | Tara Nidhi Acharya | Student in an Organized Health Care Education/Training Program | 3 E Hanauer Pl, Murray, UT 84107-3891 | 2020-06-15 |
| 1851916803 | Kenzie Harline Smith | Student in an Organized Health Care Education/Training Program | 1191 W Pitchfork Rd, Murray, UT 84123-7672 | 2020-06-15 |
| 1801415625 | Chase Jentry Mcclard | Student in an Organized Health Care Education/Training Program | 2120 Kelso Rd, Murray, KY 42071-4528 | 2020-04-12 |
| 1457970568 | Andrea Hayes | Student in an Organized Health Care Education/Training Program | 1107 Elm St, Murray, KY 42071-2345 | 2020-04-09 |
| 1457900680 | Matthew Edward Feinauer | Student in an Organized Health Care Education/Training Program | 6156 S Vinecrest Dr, Murray, UT 84121-1753 | 2019-09-10 |
| 1639721988 | William J. Fahrenbach | Student in an Organized Health Care Education/Training Program | 830 E 3990 S Apt B, Murray, UT 84107-2167 | 2019-07-16 |
| 1871045690 | Alex Coffman | Student in an Organized Health Care Education/Training Program | 5169 S Cottonwood St Ste 303, Murray, UT 84107-6768 | 2016-10-27 |
| 1245485499 | Chad Kent Christiansen | Student in an Organized Health Care Education/Training Program | 5169 Cottonwood St Ste 303, Murray, UT 84107-6768 | 2008-12-01 |
| Find all providers in MURRAY | ||||
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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.