DAVID J KELLY (NPI# 1194862417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194862417 |
| Entity Type | Individual |
| Full Name | DAVID J KELLY |
| Credential | MD |
| Practice Address |
929 Sw Simpson Ave Ste 300 Bend OR 97702-3118 |
| Mailing Address |
Po Box 670 Bend OR 97709-0670 |
| Practice Telephone | 5417063804 |
| Practice Fax Number | 5412788376 |
| Mailing Telephone | 5417063804 |
| Mailing Fax Number | 5412788376 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD155014 | OR | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | M-9938 | ID | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 47273 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807768800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386264760 | David Arnold Kelly | Student in an Organized Health Care Education/Training Program | 417 Ne 1st Ter, Oklahoma City, OK 73104-4056 | 2020-04-25 |
| 1558714238 | David Kelly | Nurse Practitioner | 101 Fornum Dr, Grovetown, GA 30813-2697 | 2016-07-19 |
| 1053727040 | David Adam Kelly | Pharmacist | 1401 S Quintard Ave, Anniston, AL 36201-8248 | 2014-07-10 |
| 1821259722 | David Alexander Kelly | Plastic Surgery | 14275 N 87th St Ste 110, Scottsdale, AZ 85260-3696 | 2008-06-23 |
| 1104014299 | David Charles Kelly Jr. | Radiologic Technologist | 8915 Cherry St, Blue Ash, OH 45242-7846 | 2007-10-15 |
| 1508057845 | David M Kelly | Prosthetist | 1900 116th Ave Ne Ste 201, Bellevue, WA 98004-3013 | 2007-08-01 |
| 1902969843 | David P Kelly | Dentist | 3275 W Ina Rd Ste 101, Tucson, AZ 85741-2152 | 2006-12-19 |
| 1124048491 | David Randolph Kelly | Dentist | 1941 Euclid Ave, Bristol, VA 24201-3607 | 2006-07-20 |
| 1154348753 | David C Kelly | Physician Assistant | Ben Hogan Center, 800 5th Ave., Suite 410, Fort Worth, TX 76104 | 2006-07-17 |
| 1184618910 | David Kelly | Specialist | 275 Sandwich St, Plymouth, MA 02360-2183 | 2005-09-08 |
| Street Address |
929 SW SIMPSON AVE STE 300 |
| City | BEND |
| State | OR |
| Zip Code | 97702-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699774877 | Paul Jennings Johnson | Family Medicine | 929 Sw Simpson Ave, Suite 300, Bend, OR 97702-3599 | 2005-07-19 |
| 1932503455 | Hannah Hogan | Acupuncturist | 929 Sw Simpson Ave, #150, Bend, OR 97702-3599 | 2014-10-13 |
| 1780092155 | Erica Danielle Crosta | Dentist | 929 Sw Simpson Ave, Bend, OR 97702-3599 | 2014-07-29 |
| 1982014049 | Nicholas Andrew Williams | Physician Assistant | 929 Sw Simpson Ave, Bend, OR 97702-3599 | 2014-04-29 |
| 1376886895 | Whitney K Drew | Physician Assistant | 929 Sw Simpson Ave, Suite 300, Bend, OR 97702-3599 | 2013-04-03 |
| 1568749687 | Mark Goodman | Counselor | 929 Sw Simpson Ave, Bend, OR 97702-3599 | 2011-11-03 |
| 1912155870 | Point Chiropractic | Chiropractor | 929 Sw Simpson Ave, Ste 140, Bend, OR 97702-3599 | 2008-09-04 |
| 1952509291 | Stacy Caldwell | Physician Assistant | 929 Sw Simpson Ave, Suite 220, Bend, OR 97702-3599 | 2007-07-09 |
| 1225104235 | Mark Thibert | Family Medicine | 929 Sw Simpson Ave, Suite 300, Bend, OR 97702-3599 | 2006-11-28 |
| 1609972439 | Dean T Nakadate | Podiatrist | 929 Sw Simpson Ave, Suite 220, Bend, OR 97702-3599 | 2006-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1083252472 | Driven Enterprises PC | Family Medicine | 20700 Wandalea Dr, Bend, OR 97701-1594 | 2019-12-16 |
| 1407404668 | Taylor Rose Stockton | Family Medicine | 19700 Sunshine Way, Bend, OR 97702-1984 | 2019-08-30 |
| 1366780066 | Anthony Gunsul | Family Medicine | 61250 Se Coombs Place, Bend, OR 97702 | 2013-01-30 |
| 1669776050 | Ralph Verlin Litchfield | Family Medicine | 21260 Bear Creek Rd, Bend, OR 97701-9602 | 2010-12-29 |
| 1750681391 | Kevin Michael Fickenscher Sr. | Family Medicine | 3499 Nw Braid Drive, Bend, OR 97701-8682 | 2010-10-29 |
| 1902030844 | Audrey H Davey | Family Medicine | 18976 Nw Squirreltail Loop, Bend, OR 97703-5932 | 2009-05-06 |
| 1366609422 | Jon Arthur Blackman | Family Medicine | 2456 Nw Sacagawea Ln, Bend, OR 97701-5722 | 2008-05-16 |
| 1316060163 | West Bend Family Medicine | Family Medicine | 2855 Nw Crossing Dr., Suite 102, Bend, OR 97703 | 2007-04-09 |
| 1962544106 | Paul Vancamp | Family Medicine | 115 Sw Allen Rd, Bend, OR 97702-3170 | 2007-02-13 |
| Find all providers in BEND | ||||
Please comment or provide details below to improve the information on DAVID J KELLY.
| 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.