KELLIE HETHERINGTON (NPI# 1285006809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285006809 |
| Entity Type | Individual |
| Full Name | KELLIE HETHERINGTON |
| Credential | DPM |
| Practice Address |
6104 Avenue Q South Dr Lubbock TX 79412-3700 |
| Mailing Address |
1600 Fillmore St Apt 310 Denver CO 80206-1579 |
| Practice Telephone | 4054089130 |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2019-07-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
338 | OK | Podiatric Medicine & Surgery Service Providers |
| Street Address |
6104 AVENUE Q SOUTH DR |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79412-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942202999 | Timothy A Mazzolini | Pharmacist | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2005-08-10 |
| 1316567670 | Wanda Jean Howard | Registered Nurse | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2020-04-16 |
| 1760014112 | Fabian Carmona | Social Worker | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2020-02-04 |
| 1346807708 | Andrea Rochelle Carrillo | Social Worker | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2019-05-21 |
| 1205394285 | Courtney E Walraven | Social Worker | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2019-03-07 |
| 1487120283 | Ericka Ann Comer | Pharmacist | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2018-10-18 |
| 1003382078 | Malory Shanks | Nurse Practitioner | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2018-10-17 |
| 1891271524 | Beverly Lynn Jones | Registered Nurse | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2018-07-16 |
| 1699210237 | Frances Shaw | Physical Therapist | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2017-01-05 |
| 1437694130 | Brittney Marie Williamson | Social Worker | 6104 Avenue Q South Dr, Lubbock, TX 79412-3700 | 2017-01-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420864 | The Kidney Care Center, LLC | Clinic/Center | 3702 Interstate 27, Lubbock, TX 79412 | 2020-02-28 |
| 1639531254 | Lori Ann Boyd | Dietitian, Registered | 2412 50 Th Street, Lubbock, TX 79412 | 2016-03-23 |
| 1073989083 | Jesse Garcia | Social Worker | 6104 Ave. Q South Drive, Lubbock, TX 79412 | 2015-08-12 |
| 1316294408 | Ronald Caporale | Physician Assistant | 1701 50th Street, Lubbock, TX 79412 | 2012-08-08 |
| 1508152901 | Lilian Francisca Hayes | Counselor | 2345 50th St., Lubbock, TX 79412 | 2011-06-23 |
| 1861787285 | Sarah Delacruz | Counselor | 2345 50th Street, Lubbock, TX 79412 | 2011-06-14 |
| 1407189558 | David G Smith | Counselor | 2345 50th Managed Care Center, Lubbock, TX 79412 | 2009-09-08 |
| 1427261205 | Barbara J Trotter | Dietitian, Registered | 5022 Ave Q, Covenant Ctr for Outpatient Diabetes Education Lubbock, Lubbock, TX 79412 | 2007-05-08 |
| 1447471057 | Elmer Artemus Addington IIi | Chiropractor | 3410 Avenue Q, Lubbock, TX 79412 | 2007-05-01 |
| 1083779805 | Shaun Hamlett Keel PC | Psychologist | 2402 52nd St., Suite 6, Lubbock, TX 79412 | 2006-12-22 |
| Find all providers in zip 79412 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147245 | George C. Bakatsas, D.p.m., L.L.C. | Podiatrist | 6849 82nd St Ste 102, Lubbock, TX 79424-5136 | 2020-02-26 |
| 1023325024 | Benjamin Lloyd Fluhman | Podiatrist | 4515 Marsha Sharp Fwy, Lubbock, TX 79407-2520 | 2010-09-12 |
| 1245474535 | Jeremiah Graff Dpm P A | Podiatrist | 2002 Oxford Ave, Suite B, Lubbock, TX 79410-1025 | 2009-04-30 |
| 1336356815 | Family Foot and Ankle Care Pllc | Podiatrist | 3702 22nd Pl, Lubbock, TX 79410-1320 | 2007-05-16 |
| 1356568604 | Jeffery Mcneely Dpm Pa | Podiatrist | 2126 50th St, Lubbock, TX 79412-2619 | 2007-04-19 |
| 1184739310 | Sean Paul Schwarzentraub | Podiatrist | 4601 66th St, Lubbock, TX 79414-4828 | 2006-08-20 |
| 1235244351 | Schwarzentraub Foot Clinic, PC | Podiatrist | 4601 66th St, Lubbock, TX 79414-4828 | 2006-08-20 |
| 1942315049 | Paul Howard Schwarzentraub | Podiatrist | 4601 66th St, Lubbock, TX 79414-4828 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748656 | Lonestar Foot and Ankle Surgical Associates, Pllc | Podiatrist | 515 E Court St Ste 300, Seguin, TX 78155-5726 | 2020-10-19 |
| 1528665437 | New Horizon Foot and Ankle Specialists | Podiatrist | 2448 Highway 121, Unit 808, Bedford, TX 76021-7317 | 2020-10-04 |
| 1467067603 | Katy Foot & Ankle Pllc | Podiatrist | 21660 Kingsland Blvd # 500, Katy, TX 77450-2511 | 2020-09-14 |
| 1154932812 | Delara Foot and Ankle Pllc | Podiatrist | 1604 Hospital Pkwy Ste 309, Bedford, TX 76022-6931 | 2020-08-14 |
| 1245858265 | Biel Foot & Ankle Specialists Pllc | Podiatrist | 19002 Park Row, Suite 100, Houston, TX 77084 | 2020-07-07 |
| 1013536952 | Select Foot and Ankle Specialists, P.l.l.c. | Podiatrist | 25222 Northwest Fwy Apt 185, Cypress, TX 77429-1038 | 2020-04-10 |
| 1871129445 | Interventional Partners LLC | Podiatrist | 17189 I 45 S Ste 285, Shenandoah, TX 77385-3320 | 2020-03-16 |
| 1073149647 | Interventional Partners LLC | Podiatrist | 18300 Katy Fwy Ste 235, Houston, TX 77094-1521 | 2020-03-16 |
| 1053947622 | Interventional Partners LLC | Podiatrist | 915 Gessner Rd Ste 380, Houston, TX 77024-2519 | 2020-03-16 |
| 1245866813 | Interventional Partners LLC | Podiatrist | 18220 Tomball Pkwy Ste 220, Houston, TX 77070-4370 | 2020-03-16 |
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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.