CASEY KELLY (NPI# 1205076015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205076015 |
| Entity Type | Individual |
| Full Name | CASEY KELLY |
| Other Name | CASEY EVENSON |
| Credential | PA |
| Practice Address |
2200 Tydd St Eureka CA 95501-1284 |
| Mailing Address |
670 9th St Suite 203 Arcata CA 95521-6248 |
| Practice Telephone | 7072697051 |
| Practice Fax Number | 7072697054 |
| Mailing Telephone | 7078268633 |
| Mailing Fax Number | 7078268638 |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2017-02-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 20196 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801421847 | Casey Marie Kelly | Registered Nurse | 1211 Medical Center Dr, Nashville, TN 37232-0004 | 2020-03-10 |
| 1427521822 | Casey Scott Kelly | Counselor | 5010 Hendersonville Rd, Fletcher, NC 28732-6606 | 2019-01-08 |
| 1174018246 | Casey Kelly | Nurse Practitioner | 2620 Eagan Woods Dr, Eagan, MN 55121 | 2018-06-29 |
| 1821504861 | Casey Kelly | Behavior Technician | 7 Cypress Dr, Burlington, MA 01803-4907 | 2017-12-27 |
| 1689024192 | Casey Kelly | Counselor | 10 Alice Peck Day Dr, Lebanon, NH 03766-2900 | 2016-06-15 |
| Street Address |
2200 TYDD ST |
| City | EUREKA |
| State | CA |
| Zip Code | 95501-1284 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033113535 | Suzanne Dietz | Nurse Practitioner | 2200 Tydd St, Eureka, CA 95501-1284 | 2005-06-13 |
| 1447864756 | Shoua Lor | Nurse Practitioner | 2200 Tydd St, Eureka, CA 95501-1284 | 2020-09-03 |
| 1487264586 | Susan Kang Blackburn | Registered Nurse | 2200 Tydd St, Eureka, CA 95501-1284 | 2020-08-04 |
| 1104434364 | Gift Oluchi Okwandu | Nurse Practitioner | 2200 Tydd St, Eureka, CA 95501-1284 | 2020-07-14 |
| 1942858790 | Haley April Davies | Nurse Practitioner | 2200 Tydd St, Eureka, CA 95501-1284 | 2019-08-26 |
| 1568010312 | Gianvieve Schwirblat | Registered Nurse | 2200 Tydd St, Eureka, CA 95501-1284 | 2019-08-26 |
| 1780230425 | Genay Marie Lebeuf | Registered Nurse | 2200 Tydd St, Eureka, CA 95501-1284 | 2019-08-16 |
| 1447817184 | Marresa Chinwe Ozokwere | Nurse Practitioner | 2200 Tydd St, Eureka, CA 95501-1284 | 2019-05-28 |
| 1104480953 | Anna Page Strunk | Registered Nurse | 2200 Tydd St, Eureka, CA 95501-1284 | 2019-04-26 |
| 1174001986 | Patricia Lan Carter | Physician Assistant | 2200 Tydd St, Eureka, CA 95501-1284 | 2018-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538795919 | Eric Meyer Goldsmith | Physical Therapist | 2306 Dean Street, Eureka, CA 95501 | 2020-03-18 |
| 1609406404 | Humboldt County Behavioral Health | Community/Behavioral Health | 638 W Clark St., Bldg. E, Eureka, CA 95501 | 2020-01-21 |
| 1740831767 | Jacqueline Renee Coghill | Nurse Practitioner | Waterfront Recovery Services, 2413 2nd St, Eureka, CA 95501 | 2019-09-20 |
| 1982177275 | Jenny Bugnacki | Case Manager/Care Coordinator | 721 Wood St, Eureka, CA 95501 | 2019-01-09 |
| 1073023107 | Humboldt Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 1303 11th St, Eureka, CA 95501 | 2017-10-03 |
| 1730698283 | Gabriel Holtski | Naturopath | 1632 Broadway, Suite #252, Eureka, CA 95501 | 2017-09-27 |
| 1164951851 | Redwood Community Services, Inc. | Foster Care Agency | 2426 6th St, Eureka, CA 95501 | 2017-06-07 |
| 1033651922 | Narum Clinical Services | Social Worker | 930 3rd St, Suite 201, Eureka, CA 95501 | 2016-11-09 |
| 1750839510 | Sierra Marie Evers-hellmich | Physical Medicine & Rehabilitation | 2103 Myrtle Avenue, Eureka, CA 95501 | 2016-09-21 |
| 1558720623 | Jennifer Vu | Behavioral Analyst | 730 7th St Ste A, Eureka, CA 95501 | 2016-02-18 |
| Find all providers in zip 95501 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326490129 | Cory Heiser | Physician Assistant | 401 9th St Ste A, Eureka, SD 57437-2183 | 2016-07-06 |
| 1801243241 | Sarah Kingstrom | Physician Assistant | 2933 Pigeon Point Rd, Eureka, CA 95503 | 2016-05-16 |
| 1033487145 | Shubhangi B Deshmukh | Physician Assistant | 2725 Myrtle Ave, Eureka, CA 95501-3425 | 2011-12-03 |
| 1881783892 | Duane Duke Gibson | Physician Assistant | 250 S. Main Street, Eureka, NV 89316 | 2006-10-11 |
| 1417059445 | Miles Miller | Physician Assistant | 995 Hwy 93 S, Eureka, MT 59917 | 2006-09-01 |
| 1932161965 | Tamra Brisbin | Physician Assistant | 1932 S Main St, Eureka, IL 61530-1666 | 2006-04-05 |
| 1891780086 | Nancy J Mckenzie | Physician Assistant | 110 E 16th St, Eureka, KS 67045-1067 | 2005-09-14 |
| 1740284686 | Mary Catherine Silver | Physician Assistant | 2367 Harrison Ave, Eureka, CA 95501-3216 | 2005-06-09 |
| 1144868803 | Kirsten Elise Stambaugh | Physician Assistant | 2440 23rd St Ste B, Eureka, CA 95501-3203 | 2019-12-12 |
| 1457908204 | Emily Pauli | Physician Assistant | 200 J Ave Ste A, Eureka, SD 57437-2225 | 2019-08-26 |
| Find all providers in EUREKA | ||||
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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.