MRS. STACY SUE KELLEY (NPI# 1174802938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174802938 |
| Entity Type | Individual |
| Full Name | MRS. STACY SUE KELLEY |
| Credential | CNP |
| Practice Address |
6515 Pullman Dr Lewis Center OH 43035-7380 |
| Mailing Address |
700 Ackerman Rd Suite 260 Columbus OH 43202-1559 |
| Practice Telephone | 6146887150 |
| Mailing Telephone | 6149473700 |
| Mailing Fax Number | 6149473771 |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2014-01-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
COA.12521-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
COA.12521 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | PENDING | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349603 | Stacy E Kelley | Massage Therapist | 312 Thalia Station Ct, Virginia Beach, VA 23452-1752 | 2020-09-02 |
| Street Address |
6515 PULLMAN DR |
| City | LEWIS CENTER |
| State | OH |
| Zip Code | 43035-7380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629031976 | Michael James Alexander | Family Medicine | 6515 Pullman Dr, Ste 2200, Lewis Center, OH 43035-7380 | 2006-04-08 |
| 1891114989 | Jodi Lynn Kuri | Physical Therapist | 6515 Pullman Dr, Lewis Center, OH 43035-7380 | 2014-04-16 |
| 1821319773 | Kevin Daniel Springer | Podiatrist | 6515 Pullman Dr, Lewis Center, OH 43035-7380 | 2010-06-15 |
| 1982811352 | Timothy Lee Miller | Orthopaedic Surgery | 6515 Pullman Dr, Suite 1100, Lewis Center, OH 43035-7380 | 2007-05-16 |
| 1124142898 | Erin Elizabeth Mcconnell | Internal Medicine | 6515 Pullman Dr, Lewis Center, OH 43035-7380 | 2007-03-19 |
| 1881605194 | Nazhat Taj-schaal | Internal Medicine | 6515 Pullman Dr, Suite 2200, Lewis Center, OH 43035-7380 | 2006-08-11 |
| 1609831270 | Deborah A Gordish | Internal Medicine | 6515 Pullman Dr, Suite 2200, Lewis Center, OH 43035-7380 | 2006-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949358 | Lester Chinjelu Zitto | Homemaker | 910 Apt C Polaris Grand Drive, Lewis Center, OH 43035 | 2020-10-12 |
| 1053959072 | Fixari Dental of Lewis Center LLC | Dentist | 8300 Orange Centre Dr, Lewis Center, OH 43035 | 2019-12-20 |
| 1932752037 | Dianna Lynn Hartley | Registered Nurse | 630 East River Road, Elyria, OH 43035 | 2019-07-18 |
| 1972164713 | Cardinal Delaware, Inc. | Skilled Nursing Facility | 6975 Graphics Way, Lewis Center, OH 43035 | 2019-06-24 |
| 1770142168 | Huong V. Trinh, Dds, LLC | Dentist | 599 Carle Ave, Lewis Center, OH 43035 | 2019-06-10 |
| 1245691476 | Isatou Aisha Saidy | Registered Nurse | 8014 Strawberry Hill Rd, Lewis Center, OH 43035 | 2016-03-16 |
| 1467875864 | Karen Leigh Richeson | Physical Therapist | 814 Lewis Center Rd, Lewis Center, OH 43035 | 2014-01-22 |
| 1750609970 | Roopan Elizabeth Farris | Internal Medicine | 6515 Pullman Drive, Lewis Center, OH 43035 | 2010-05-12 |
| 1164655429 | Pagie Kondoh Yokie | Registered Nurse | 812 Mystic Pointe Drive, Lewis Center, OH 43035 | 2009-09-02 |
| 1215193644 | Amanda Rose Daugherty | Nurse Practitioner | 6417 Columbus Pike, Lewis Center, OH 43035 | 2008-08-05 |
| Find all providers in zip 43035 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394235 | Lisa Ann Popovich | Nurse Practitioner | 3703 Canon Ridge Pl, Columbus, OH 43230-4010 | 2020-10-17 |
| 1598362402 | Kate Suzanne Mccombs | Nurse Practitioner | 6681 Ridge Rd Ste 30, Parma, OH 44129-5705 | 2020-10-04 |
| 1013523745 | Yangyang Hu | Nurse Practitioner | 2042 Golden Oaks Dr, Kent, OH 44240-8198 | 2020-09-17 |
| 1659982494 | Lauren Rainey | Nurse Practitioner | 70 N Hillside Rd, Canfield, OH 44406-1335 | 2020-08-14 |
| 1932710928 | Bobbie Duda | Nurse Practitioner | 6454 Paine Rd, Painesville, OH 44077-9318 | 2020-08-12 |
| 1235756461 | Sara Mauk | Nurse Practitioner | 6780 Mayfield Rd Rm 323, Mayfield Heights, OH 44124-2203 | 2020-07-04 |
| 1629694153 | Laraine Elizabeth Tench | Nurse Practitioner | 9500 Euclid Ave # G110, Cleveland, OH 44195-0001 | 2020-06-20 |
| 1316563109 | Isabelle Noffsinger | Nurse Practitioner | 6443 Far Hills Ave, Washington Township, OH 45459-2725 | 2020-06-17 |
| 1497375604 | Allison Ferguson | Nurse Practitioner | 3641 Shepherd St Nw, North Canton, OH 44720-7949 | 2020-04-17 |
| 1154940708 | Elizabeth Clare Gaydosh | Nurse Practitioner | 4680 Autumn Run Dr, Medina, OH 44256-8821 | 2020-04-14 |
| Find all providers with the same taxonomy | ||||
| City | LEWIS CENTER |
| Zip Code | 43035 |
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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.