SHARON MAGGIE KELLY (NPI# 1235695206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235695206 |
| Entity Type | Individual |
| Full Name | SHARON MAGGIE KELLY |
| Practice Address |
4747 W 24th Ave Gary IN 46406-2821 |
| Practice Telephone | 2192408615 |
| Practice Fax Number | 2199771197 |
| Mailing Telephone | 2192408615 |
| Mailing Fax Number | 2199771197 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205497369 | Sharon L Kelly | Prosthetist | 20 Affonso Dr, Carson City, NV 89706-7815 | 2019-06-27 |
| 1265633960 | Sharon Kelly | Psychologist | 210 West Gay Street, Westchester, PA 19380 | 2007-05-30 |
| 1033325683 | Sharon Ann Kelly | Social Worker | 3420 E Shea Blvd Ste 215, Phoenix, AZ 85028-3345 | 2007-05-14 |
| 1609932730 | Sharon M Kelly | Pharmacy Technician | 11 Batchelder Rd, Seabrook, NH 03874-4402 | 2007-01-01 |
| 1447344346 | Sharon Michele Kelly | Social Worker | 5906 Park Heights Ave, Suite 107-12, Baltimore, MD 21215-3631 | 2006-10-03 |
| 1366427155 | Sharon K Kelly | Pharmacist | 5799 Springboro Pike, West Carrollton, OH 45449-2807 | 2005-12-14 |
| 1790774057 | Sharon Kay Kelly | Nurse Practitioner | 2010 Wilshire Blvd, Los Angeles, CA 90057-3507 | 2005-10-19 |
| 1013482348 | Sharon Kelly | Massage Therapist | 801 W Bay Dr Ste 500, Largo, FL 33770-3220 | 2018-10-13 |
| 1215062658 | Sharon Kelly | Counselor | 3020 Old Ranch Pkwy, Ste 300, Seal Beach, CA 90740-2751 | 2007-02-23 |
| 1184772923 | Sharon P. Kelly | Nurse Practitioner | John Dempsey Hospital, 263 Farmington Avenue, Mc-2203, Farmington, CT 06030-0001 | 2007-01-08 |
| Street Address |
4747 W 24TH AVE |
| City | GARY |
| State | IN |
| Zip Code | 46406-2821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184757320 | Middle Passage, Incorporated | Community/Behavioral Health | 4747 W 24th Ave, Gary, IN 46406-2821 | 2007-03-14 |
| 1265049845 | Rebecca Soboleski | Peer Specialist | 4747 W 24th Ave, Gary, IN 46406-2821 | 2020-09-28 |
| 1982213468 | Iris Jeffries | Technician | 4747 W 24th Ave, Gary, IN 46406-2821 | 2020-07-30 |
| 1194384073 | Khaliah Amani Herbert | Technician, Health Information | 4747 W 24th Ave, Gary, IN 46406-2821 | 2019-06-13 |
| 1033697032 | Ladonna Lucille Bell | Registered Nurse | 4747 W 24th Ave, Gary, IN 46406-2821 | 2018-08-01 |
| 1154819597 | Zakia Brodnax | Technician, Health Information | 4747 W 24th Ave, Gary, IN 46406-2821 | 2018-05-01 |
| 1184153827 | Stacey Williams | Registered Nurse | 4747 W 24th Ave, Gary, IN 46406-2821 | 2017-06-07 |
| 1205373347 | Terronda Hurn | Registered Nurse | 4747 W 24th Ave, Gary, IN 46406-2821 | 2017-01-27 |
| 1588036974 | Demia Chandler | Nurse's Aide | 4747 W 24th Ave, Gary, IN 46406-2821 | 2015-10-24 |
| 1871965384 | Danielle Elizabeth Carter | Licensed Practical Nurse | 4747 W 24th Ave, Gary, IN 46406-2821 | 2015-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134380009 | Aspire Academy | Local Education Agency (LEA) | 4900 W 15th Ave, Gary, IN 46406 | 2008-06-23 |
| 1821118589 | Comprehensive Physical Therapy | Physical Therapist | 7501 W. 15th Ave, Gary, IN 46406 | 2007-03-29 |
| 1205973336 | Comprehensive Therapy, Inc. | Physical Therapist | 7501 W. 15th Ave., Gary, IN 46406 | 2007-01-30 |
| 1588603286 | Bryan Michael Buksar | Physical Therapist | 7101 West 17th Avenue, Gary, IN 46406 | 2006-06-06 |
| 1285753103 | Comprehensive Care | Preventive Medicine | 7501 W. 15th Ave., Gary, IN 46406 | 2007-03-29 |
| 1891832929 | Michael Foreit | General Practice | 7501 W. 15th Ave., Gary, IN 46406 | 2007-01-30 |
| 1740327873 | Frank Messana | General Practice | 7501 W. 15th Ave., Gary, IN 46406 | 2007-01-30 |
| 1760651863 | Tolanda Somerville | Speech-Language Pathologist | 5901 W 7th Ave, Gary, IN 46406-1311 | 2008-02-22 |
| 1598934697 | Lisa Previs | Developmental Therapist | 5901 W 7th Ave, Gary, IN 46406-1311 | 2008-02-22 |
| 1598005423 | National Mentor Healthcare LLC | Custodial Care Facility | 6032 W 7th Ave, Gary, IN 46406-1314 | 2013-03-01 |
| Find all providers in zip 46406 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346630118 | Renita Ware | Community Based Residential Treatment Facility, Mental Illness | 1003 Colfax St, Gary, IN 46406-1903 | 2015-01-30 |
| 1841609641 | Yvonne Williams | Community Based Residential Treatment Facility, Mental Illness | 444 Fillmore St, Gary, IN 46402-1036 | 2014-08-05 |
| 1285086561 | Megan Ballard | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-07-11 |
| 1922456896 | Rosalind Pirtle | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-06-01 |
| 1497103360 | Gene George | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-06-01 |
| 1427410216 | Keith Artison | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-03-22 |
| 1861854655 | Ella Johnson | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-03-22 |
| 1679935399 | Jennifer Sykes | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-03-22 |
| 1922460716 | Nika Pickens | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-03-22 |
| 1801254461 | Deborah Jackson | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402 | 2016-02-10 |
| Find all providers in GARY | ||||
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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.