DAVID LEE KELLY JR. (NPI# 1255310587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255310587 |
| Entity Type | Individual |
| Full Name | DAVID LEE KELLY JR. |
| Credential | MD |
| Practice Address |
Medical Center Blvd Winston Salem NC 27157-0001 |
| Mailing Address |
Po Box 344 Winston Salem NC 27102-0344 |
| Practice Telephone | 3367162255 |
| Practice Fax Number | 3367162907 |
| Mailing Telephone | 3367162255 |
| Mailing Fax Number | 3367162907 |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2010-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 11526 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 204068000 | 05 | |
| NC | MEDCOST | 26310 | 01 |
| SC | Q11526 | 05 | |
| VA | 6133801 | 05 | |
| NC | PARTNERS | 2875 | 01 |
| NC | AETNA | 4382149 | 01 |
| NC | BCBS | 48205 | 01 |
| NC | 8948205 | 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 |
MEDICAL CENTER BLVD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27157-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811990815 | Gary Lee Ray | Registered Nurse | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-05-23 |
| 1881295418 | Alan Townes Grizzard | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-11-02 |
| 1003421751 | Nicholas Ryan Tuttle | Nurse Anesthetist, Certified Registered | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-09-10 |
| 1356956122 | Caitlin Marie Clement | Nurse Anesthetist, Certified Registered | Medical Center Blvd, Winston Salem, NC 27103 | 2020-09-09 |
| 1376154591 | Lori Sansone Flores | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-08-11 |
| 1821609330 | Hannah Carey Walker | Physician Assistant | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-08-10 |
| 1447876883 | Raveena Mahesh Chhabria | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-06-22 |
| 1780205930 | Jason Chin | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-1087 | 2020-04-29 |
| 1972122885 | Bryanna Dean Vesely | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-04-10 |
| 1679102909 | Ameen Barghi | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-2803 | 2020-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255960241 | Alexandra Marie Balmaceda | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Pathology Dept, #1 Medical Center Blvd., Winston-salem, NC 27157 | 2020-04-02 |
| 1164916680 | Jorie Elizabeth Gatts | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Department of Pediatrics, Winston Salem, NC 27157 | 2018-06-18 |
| 1932606555 | Alexi Rae Ellington Webb | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine, Dept of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-04-10 |
| 1851896674 | Wasim Muhammad | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-03-25 |
| 1336643535 | Phillip Martin Kostelic | Student in an Organized Health Care Education/Training Program | Anesthesiology - Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-salem, NC 27157 | 2018-03-21 |
| 1831693324 | Aleah Bond | Student in an Organized Health Care Education/Training Program | Anesthesiology Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-salem, NC 27157 | 2018-03-20 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1023467529 | Edward John Doyle IIi | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Otolaryngology, Watlington Hall 4th Fl. Medical Center Boulevard, Winston-salem, NC 27157 | 2016-06-07 |
| 1477917888 | Jordan Mae Burner | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Office, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-salem, NC 27157 | 2016-04-12 |
| 1174900476 | Kate Elise Winterbottom | Speech-Language Pathologist | 4 Janeway Medical Center Blvd, Hearing and Speech, Winston Salem, NC 27157 | 2015-05-06 |
| Find all providers in zip 27157 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306228028 | Charles Rawlings IIi | Neurological Surgery | 426 Old Salem Rd, Winston Salem, NC 27101-5268 | 2015-06-19 |
| 1497080006 | Novant Medical Group Inc | Neurological Surgery | 190 Kimel Park Dr Ste 155, Winston Salem, NC 27103-6946 | 2009-10-15 |
| 1568606747 | Mark Russell Witcher | Neurological Surgery | Dept. of Neurosurgery, Wake Forest University, Baptist Medical Center, Medical Center Blvd., Winston Salem, NC 27127-7580 | 2009-05-01 |
| 1003083148 | Dennis Michael Campbell | Neurological Surgery | 185 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6973 | 2008-05-08 |
| 1003917725 | Neurosurgical Associates of The | Neurological Surgery | 2810 Maplewood Ave, Winston Salem, NC 27103-4138 | 2006-09-26 |
| 1396798732 | Thomas A Sweasey | Neurological Surgery | 185 Kimel Park Dr Ste 201, Winston Salem, NC 27103-6973 | 2006-05-18 |
| 1891317152 | Serdar Kaya | Neurological Surgery | Medical Center Blvd Janeway Tower 4th Floor, Winston Salem, NC 27157-0001 | 2020-05-09 |
| 1700207818 | Neurosurgery and Pain Specialists of The Carolinas, P.C. | Neurological Surgery | 730 Highland Oaks Dr, Suite 105, Winston Salem, NC 27103-7154 | 2013-12-17 |
| 1063764140 | Adrian Walter Laxton | Neurological Surgery | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2012-10-12 |
| 1215222302 | Phillip Robert Dagostino | Neurological Surgery | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2011-06-16 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27157 |
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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.