COLLEEN R KELLY (NPI# 1245268754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245268754 |
| Entity Type | Individual |
| Full Name | COLLEEN R KELLY |
| Other Name | COLLEEN R. KELLY-PERKINS |
| Credential | P.A. |
| Practice Address |
3651 College Blvd Leawood KS 66211-1910 |
| Mailing Address |
12639 Old Tesson Rd Suite 100 Saint Louis MO 63128-2786 |
| Practice Telephone | 9133197633 |
| Practice Fax Number | 9132531764 |
| Mailing Telephone | 3148490311 |
| Mailing Fax Number | 3148494423 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2019-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
119557 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1500630 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BCBS-KC | 40122016 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417451980 | Colleen Anne Kelly | Student in an Organized Health Care Education/Training Program | Menino Building, Dowling 3 South Resident Mailboxes, 1 Boston Medical Center Place, Boston, MA 02118 | 2018-03-20 |
| 1982068474 | Colleen Kelly | Counselor | 3208 Lake Park Way, 105, Longmont, CO 80503-7822 | 2016-04-11 |
| 1023498565 | Colleen Emma Kelly | Behavioral Analyst | 48 Aberdeen Rd, Arlington, MA 02476-5752 | 2015-05-29 |
| 1386714590 | Colleen J Kelly | Nurse Practitioner | Walton High School, 2780 Reservoir Avenue, Bronx, NY 10468 | 2006-11-08 |
| 1801839121 | Colleen Elizabeth Kelly | Pediatrics | 21 Totman Street, #2, Quincy, MA 02169 | 2006-06-14 |
| 1205440591 | Colleen Kelly | Social Worker | 7701 13th Ave, Brooklyn, NY 11228-2413 | 2020-09-03 |
| 1265068696 | Colleen Kelly | Physical Therapist | 460 Amherst St, Nashua, NH 03063-1220 | 2020-03-17 |
| 1790320414 | Colleen Kelly | Occupational Therapist | 3761 Knollcroft St, Easton, PA 18045-3026 | 2019-11-18 |
| 1407400419 | Colleen Lora Jaimie Kelly | Nurse Practitioner | 2111 Neuse Blvd Ste J, New Bern, NC 28560-4318 | 2019-07-29 |
| 1811457815 | Colleen Hamm Kelly | Surgery | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2019-03-25 |
| Street Address |
3651 COLLEGE BLVD |
| City | LEAWOOD |
| State | KS |
| Zip Code | 66211-1910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508864208 | Cris D Barnthouse | Orthopaedic Surgery | 3651 College Blvd, #100a, Leawood, KS 66211-1904 | 2005-07-07 |
| 1194283457 | Danielle Marie Herman | Registered Nurse | 3651 College Blvd, Leawood, KS 66211-1910 | 2019-03-06 |
| 1619428034 | Katie A Macdonald | Nurse Practitioner | 3651 College Blvd, Leawood, KS 66211-1910 | 2016-10-20 |
| 1275998213 | Kylie A Yuhas | Physician Assistant | 3651 College Blvd, Ste 100b, Leawood, KS 66211-1910 | 2015-12-17 |
| 1780001024 | Annie M Muehlberger | Nurse Practitioner | 3651 College Blvd, Leawood, KS 66211-1910 | 2014-03-25 |
| 1922437813 | Erica Audelo Mcgriff | Physician Assistant | 3651 College Blvd, Suite 100b, Leawood, KS 66211-1910 | 2013-11-01 |
| 1619314085 | Karen W. Cason | Physician Assistant | 3651 College Blvd, Leawood, KS 66211-1910 | 2013-05-25 |
| 1841561750 | James P Halloran | Orthopaedic Surgery | 3651 College Blvd, Leawood, KS 66211-1910 | 2012-01-24 |
| 1831475599 | Courtney Rae Iverson | Physician Assistant | 3651 College Blvd, Suite 100b, Leawood, KS 66211-1910 | 2011-10-26 |
| 1659698561 | Nicholas T Ting | Orthopaedic Surgery | 3651 College Blvd, Leawood, KS 66211-1910 | 2010-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407098395 | Kara Leigh-lawless Boyd | Physician Assistant | 3651 College Boulevard, Leawood, KS 66211 | 2009-03-24 |
| 1275998213 | Kylie A Yuhas | Physician Assistant | 3651 College Blvd, Ste 100b, Leawood, KS 66211-1910 | 2015-12-17 |
| 1922437813 | Erica Audelo Mcgriff | Physician Assistant | 3651 College Blvd, Suite 100b, Leawood, KS 66211-1910 | 2013-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675725 | Jordan Levi Walter | Physician Assistant | Associated Urologsits P A, 1133 College Ave G100, Manhattan, KS 66502-2756 | 2019-05-29 |
| 1316217102 | Tina L Lee | Physician Assistant | 15263 Sweetbriar Dr, Basehor, KS 66007-3031 | 2012-01-10 |
| 1053446708 | Eastern Surgical Assistants, LLC | Physician Assistant | 16427 Metro Ave, Bonner Springs, KS 66012-7108 | 2007-02-22 |
| 1730223785 | Ty M. Taylor | Physician Assistant | 8321 Alden St, Lenexa, KS 66215-4213 | 2007-02-16 |
| 1366457038 | Gustav Thomas Riemer | Physician Assistant | 9119 W. 74th Street, Suite 354, Shawnee Mission Medical Building, Merriam, KS 66204 | 2006-07-30 |
| 1699795112 | Kenneth Brian Filsinger | Physician Assistant | 1112 W 6th St Ste 124, Lawrence, KS 66044-2249 | 2006-07-20 |
| 1962435552 | Gregory Bryan De Laney | Physician Assistant | 1431 Bluffview St Ste 210, Wichita, KS 67218-3039 | 2006-07-08 |
| 1538122973 | Leah Alpers | Physician Assistant | 351 W 10th St, Hoisington, KS 67544-1715 | 2006-04-07 |
| 1275596611 | Anne Linenberger | Physician Assistant | 1514 K 96 Highway, Great Bend, KS 67530 | 2006-04-07 |
| 1669433652 | Mark Lee Pemberton | Physician Assistant | 9119 W 74th St Ste 260, Shawnee Mission, KS 66204-2268 | 2006-03-29 |
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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.