KELLIE DANGLIS (NPI# 1275952970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275952970 |
| Entity Type | Individual |
| Full Name | KELLIE DANGLIS |
| Credential | FNP |
| Practice Address |
900 Elmgrove Rd Genesis Pediatrics, LLC Rochester NY 14624-6236 |
| Practice Telephone | 5854264100 |
| Practice Fax Number | 5854263701 |
| Mailing Telephone | 5854264100 |
| Mailing Fax Number | 5854263701 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2019-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F338754 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
900 ELMGROVE RD GENESIS PEDIATRICS, LLC |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14624-6236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972720530 | Jennifer L Radi | Pediatrics | 900 Elmgrove Rd, Rochester, NY 14624-6236 | 2007-04-18 |
| 1346852936 | Jessica Benway | Nurse Practitioner | 900 Elmgrove Rd, Rochester, NY 14624-6236 | 2020-08-17 |
| 1720601511 | Caitlynn Fantigrossi | Nurse Practitioner | 900 Elmgrove Rd, Rochester, NY 14624-6236 | 2020-05-27 |
| 1316364391 | Wail Tfankji | Pediatrics | 900 Elmgrove Rd, Rochester, NY 14624-6236 | 2014-03-27 |
| 1972893063 | Emilia Maria Nymander | Pediatrics | 900 Elmgrove Rd, Genesis Pediatrics, LLC, Rochester, NY 14624-6236 | 2011-04-11 |
| 1801110697 | Emilie Ellicott | Pediatrics | 900 Elmgrove Rd, Rochester, NY 14624-6236 | 2010-03-23 |
| 1487844346 | Ana Maria Stoica | Pediatrics | 900 Elmgrove Rd, Rochester, NY 14624-6236 | 2007-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871131797 | Tim's Trim Inc. | Contractor | 25 Bermar Park, Rochester, NY 14624 | 2019-12-11 |
| 1659830537 | Onita Princene Thomas | Non-emergency Medical Transport (VAN) | 38 Mulcahy Blvd, Rochester, NY 14624 | 2019-03-19 |
| 1770091852 | Brittany Richards | Case Manager/Care Coordinator | 1860 Buffalo Road, Rochester, NY 14624 | 2018-01-11 |
| 1912431123 | Ashley Marie Mooney | Dentist | 2300 Buffalo Rd Bldg 400, Rochester, NY 14624 | 2017-04-13 |
| 1396195079 | State of New York Comptrollers Office | Clinic/Center | 40 Bermar St, Rochester, NY 14624 | 2016-06-14 |
| 1134520729 | Karleigh J Sharp | Physician Assistant | 1160 Chili Ave., Suite 200, Rochester, NY 14624 | 2014-09-15 |
| 1174945398 | Lorraine Clarissa Bryan | Licensed Practical Nurse | 2 Hinkley Lane, Gates, NY 14624 | 2014-01-07 |
| 1053749614 | Amy Desantis | Physician Assistant | 9 Merrydale Drive, Rochester, NY 14624 | 2013-10-17 |
| 1700212388 | Monique Shiree Lawrence | Licensed Practical Nurse | 103 Norway Spruce Drive, Rochester, NY 14624 | 2013-09-16 |
| 1497019921 | Emily Lengen | Specialist | 6 Alderbrook Trail, Rochester, NY 14624 | 2012-06-29 |
| Find all providers in zip 14624 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1073111738 | Melissa E Spencer | Nurse Practitioner | 1338 E Ridge Rd Ste 101, Rochester, NY 14621-2017 | 2020-10-15 |
| 1295345254 | Kristin Colleen Fleming | Nurse Practitioner | 400 Red Creek Dr Ste 110, Rochester, NY 14623-4273 | 2020-08-05 |
| 1043820251 | Michelle Katherine Hiczun | Nurse Practitioner | 20 Hagen Dr Ste 330, Rochester, NY 14625-2664 | 2020-08-03 |
| 1689296949 | Suzanne Lee Bundrick | Nurse Practitioner | 1921 Westwood Ct Sw, Rochester, MN 55902-1170 | 2020-05-09 |
| 1649818931 | Erin Elizabeth Akins | Nurse Practitioner | 1882 Winton Rd S Ste 3, Rochester, NY 14618-3950 | 2019-12-17 |
| 1912544107 | Bethany Anderson Ganz | Nurse Practitioner | 115 16th Ave Nw, Rochester, MN 55901-0347 | 2019-12-06 |
| 1164068383 | Christina Kosachook | Nurse Practitioner | 990 South Ave Ste 104, Rochester, NY 14620-2740 | 2019-11-22 |
| 1073159679 | Avellina Ihuaku Okafor | Nurse Practitioner | 1328 Ridgeway Ave, Rochester, NY 14615-3716 | 2019-11-19 |
| 1053961409 | Melissa Guu-shyuan Feng | Nurse Practitioner | 995 Senator Keating Blvd Ste 3100, Rochester, NY 14618-2778 | 2019-09-18 |
| Find all providers in ROCHESTER | ||||
Please comment or provide details below to improve the information on KELLIE DANGLIS.
| 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.