DR. JOHN EDWIN KELLEY (NPI# 1316186414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316186414 |
| Entity Type | Individual |
| Full Name | DR. JOHN EDWIN KELLEY |
| Credential | PH.D. |
| Practice Address |
12647 Olive Blvd Suite 600 Saint Louis MO 63141-6393 |
| Practice Telephone | 3147444222 |
| Mailing Telephone | 3147444222 |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY6703 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750910436 | John S Kelley | Internal Medicine | 2401 S 31st St # Ms -ag, Temple, TX 76508-0001 | 2020-04-05 |
| 1225415557 | John Christopher Kelley | Psychologist | 8600 Fathom Cir, 2404, Austin, TX 78750-3037 | 2015-05-06 |
| 1770876559 | John P Kelley | Counselor | 4550 E Fifth St, Tucson, AZ 85711 | 2011-05-26 |
| 1437378965 | John M Kelley Jr. | Dentist | 1533 Merrimac Cir, Suite 207, Fort Worth, TX 76107-6571 | 2007-04-24 |
| 1518007467 | John Stewart Kelley | Counselor | 1949 Snowberry Ln, Joplin, MO 64804-5420 | 2007-02-08 |
| 1801942289 | John Roy Kelley Jr. | Dentist | 3733 Southside Blvd, Suites 5 & 6, Jacksonville, FL 32216-4684 | 2007-01-26 |
| 1568516060 | John Paul Kelley | Case Manager/Care Coordinator | 709 Nw Everett St, Portland, OR 97209-3517 | 2007-01-22 |
| 1598869877 | John Paul Kelley | Physical Medicine & Rehabilitation | 7301 East 2nd St, Ste 315, Scottsdale, AZ 85251-5627 | 2006-09-08 |
| 1740229038 | John W Kelley | Internal Medicine | 191 Deep South Farm Rd, Blairsville, GA 30512-2220 | 2006-06-05 |
| 1063414555 | John S Kelley | Obstetrics & Gynecology | 517 Rose St, Las Vegas, NV 89106-4020 | 2005-08-15 |
| Street Address |
12647 OLIVE BLVD SUITE 600 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-6393 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506673 | Paul F. Howard | Internal Medicine | 12647 Olive Blvd, Ste 600, Saint Louis, MO 63141-6345 | 2005-05-27 |
| 1548734353 | Apiphanie Lujan | Counselor | 12647 Olive Blvd, Saint Louis, MO 63141-6393 | 2019-01-15 |
| 1881115624 | Trenise Lynette Brown | Social Worker | 12647 Olive Blvd, Saint Louis, MO 63141-6393 | 2017-07-01 |
| 1336676006 | Amanda Brown Kidwell | Counselor | 12647 Olive Blvd, Ste 200, Saint Louis, MO 63141-6393 | 2017-05-12 |
| 1346776291 | Jessica Brown | Counselor | 12647 Olive Blvd, Saint Louis, MO 63141-6393 | 2017-05-11 |
| 1356877195 | Anne Tichacek | Social Worker | 12647 Olive Blvd, Saint Louis, MO 63141-6393 | 2017-05-11 |
| 1689100901 | Jenny Deutsch | Social Worker | 12647 Olive Blvd, Suite 200, Saint Louis, MO 63141-6393 | 2017-05-05 |
| 1932635299 | Qiyun Gao | Social Worker | 12647 Olive Blvd, Suite 200, Saint Louis, MO 63141-6393 | 2017-05-05 |
| 1831625169 | Lisa M Flamion | Counselor | 12647 Olive Blvd, Suite 200, Saint Louis, MO 63141-6393 | 2017-05-05 |
| 1396271664 | Jennifer L. Brown | Social Worker | 12647 Olive Blvd, Suite 200, Saint Louis, MO 63141-6393 | 2017-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174147649 | Melissa Turkel | Psychologist | 915 N Grand Blvd # 116-jc, Saint Louis, MO 63106-1621 | 2020-06-01 |
| 1629600085 | Dr Richard Heise LLC | Psychologist | 10621 Midland Manor Ct, Saint Louis, MO 63114-1202 | 2020-02-04 |
| 1598302226 | Taylor Montgomery | Psychologist | 12837 Flushing Meadows Dr Ste 220, Saint Louis, MO 63131-1824 | 2019-12-02 |
| 1265917884 | Gillian Sloane Mayersohn | Psychologist | 1 Childrens Pl Ste 3n14, Saint Louis, MO 63110-1002 | 2018-09-28 |
| 1265944466 | Brittany Jacobson | Psychologist | 1 Jefferson Barracks Rd # 116b, Saint Louis, MO 63125-4181 | 2017-10-27 |
| 1801316690 | David Howard Morris | Psychologist | 4921 Parkview Pl # 90-35703, Saint Louis, MO 63110-1032 | 2017-06-22 |
| 1144774647 | Carolyn Ashley Myles Versical | Psychologist | 26 Godwin Ln, Saint Louis, MO 63124 | 2016-08-12 |
| 1376980326 | Joshua Paul Beaman-kogan | Psychologist | 1 University Blvd # 232, Stadler Hall, Saint Louis, MO 63121-4400 | 2013-05-31 |
| 1104176064 | Brooke Kraushaar,psy.d,llc | Psychologist | 6321 Alamo Ave, Saint Louis, MO 63105-3103 | 2012-09-18 |
| 1326335837 | Jeremiah Weinstock | Psychologist | 3511 Laclede Ave, Shannon Hall, Room 208, Saint Louis, MO 63103-2010 | 2011-07-05 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on DR. JOHN EDWIN KELLEY.
| 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.