KENNETH KELLY (NPI# 1336364660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336364660 |
| Entity Type | Individual |
| Full Name | KENNETH KELLY |
| Practice Address |
1118 W Aztec Blvd Aztec NM 87410-1818 |
| Mailing Address |
212 N Valley Blvd Bloomfield NM 87413-5749 |
| Practice Telephone | 5053343695 |
| Mailing Telephone | 6029993618 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2010-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
AZ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548790454 | Kenneth Kelly | Hearing Instrument Specialist | 1754 Madison St Ste A, Clarksville, TN 37043-2923 | 2017-06-13 |
| 1205052487 | Kenneth Gregory Kelly | Psychologist | 2297 Knowles Flat Rd, Eden, VT 05652 | 2007-04-17 |
| 1821301961 | Kenneth Jason Kelly | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2010-07-19 |
| 1598902512 | Kenneth Brian Kelly | Dentist | 201 Pleasant Valley Rd, Franklin, KY 42134-2722 | 2009-01-13 |
| 1396914990 | Kenneth Raymond Kelly | Dentist | 402 Princeton Rd, Suite A, Johnson City, TN 37601-2057 | 2008-02-27 |
| 1730224908 | Kenneth J Kelly | Emergency Medicine | 2000 Trident Way, San Diego, CA 92155-5599 | 2007-02-21 |
| 1003883083 | Kenneth J. Kelly | Dentist | 111 Grossman Dr, Braintree, MA 02184-4997 | 2006-03-08 |
| 1740255942 | Kenneth Farrel Kelly | Emergency Medicine | 2669 Scenic Dr, Alamogordo, NM 88310-8700 | 2006-02-21 |
| Street Address |
1118 W AZTEC BLVD |
| City | AZTEC |
| State | NM |
| Zip Code | 87410-1818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201473 | Laurel Martin | Registered Nurse | 1118 W Aztec Blvd, Aztec, NM 87410-1818 | 2020-09-28 |
| 1528679487 | Julia Pagano | Speech-Language Pathologist | 1118 W Aztec Blvd, Aztec, NM 87410-1818 | 2020-08-13 |
| 1275175531 | Amber Gipson | Local Education Agency (LEA) | 1118 W Aztec Blvd, Aztec, NM 87410-1818 | 2019-10-08 |
| 1902372048 | Patricia Rosenberger | Local Education Agency (LEA) | 1118 W Aztec Blvd, Aztec, NM 87410-1800 | 2018-10-16 |
| 1316486855 | Sarah Anne Thomason | Registered Nurse | 1118 W Aztec Blvd, Aztec, NM 87410 | 2017-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467095448 | Kendill May Jones | Technician | 403 Andrew D, Aztec, NM 87410 | 2019-10-23 |
| 1831346469 | Suzette Lorraine Gordon | Psychologist | 1607 W. Aztec Blvd., Aztec Municipal Schools, Aztec, NM 87410 | 2008-08-26 |
| 1730392101 | Jack Fields Sona II | Pharmacist | Jack Sona, Rph, 100 Llano St, Aztec, NM 87410 | 2007-05-08 |
| 1093888380 | Bryan Standley Poe | Family Medicine | 406 S Park Ave, Aztec, NM 87410 | 2006-11-16 |
| 1467531921 | Katherine Andersen | Acupuncturist | 606 South Rio Grande Ave., Suite B, Aztec, NM 87410 | 2006-11-03 |
| 1861467433 | San Juan Regional Medical Center Inc | Internal Medicine | 120 Llano St, Aztec, NM 87410 | 2006-02-17 |
| 1649262502 | Kare Inc | Pharmacy | 100 Llano St., Aztec, NM 87410 | 2005-08-17 |
| 1871023044 | Rebekah Leann French | Nurse Practitioner | 120 Llano St, Aztec, NM 87410 | 2017-06-19 |
| 1629257092 | Karen L Vogel | Speech-Language Pathologist | 455 N Light Plant Rd, Aztec, NM 87410-1517 | 2007-11-01 |
| 1033728340 | Julia Mckeithen | Speech-Language Pathologist | 455 N Light Plant Rd, Aztec, NM 87410-1517 | 2020-07-23 |
| Find all providers in zip 87410 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831346469 | Suzette Lorraine Gordon | Psychologist | 1607 W. Aztec Blvd., Aztec Municipal Schools, Aztec, NM 87410 | 2008-08-26 |
| 1366722027 | Barbara Jean Snyder | Psychologist | 1607 W Aztec Blvd, Aztec, NM 87410-1805 | 2011-08-25 |
| 1518298256 | Marilyn Baker Stroud | Psychologist | 1607 W Aztec Blvd, Aztec, NM 87410-1805 | 2010-01-20 |
| 1619156288 | Kathleen A Price | Psychologist | 1607 W Aztec Blvd, Aztec, NM 87410-1805 | 2007-10-30 |
| 1659550804 | Sylvia Salzer | Psychologist | 1607 W Aztec Blvd, Aztec, NM 87410-1805 | 2007-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703701 | Cara Jean Burrola | Psychologist | 1111 Capitan St Nw, Los Lunas, NM 87031-6909 | 2020-09-08 |
| 1619528510 | Heather Scott | Psychologist | Highway 64, Old High School Road, Shiprock, NM 87420 | 2019-09-23 |
| 1548826829 | Stephanie Trujillo | Psychologist | 2810 N. Swan St., Silver City, NM 88061 | 2019-05-13 |
| 1003384181 | Patricia Keeler | Psychologist | # 50 County Rd. 13, Cuba, NM 87013 | 2018-11-07 |
| 1427562107 | Tascha Just | Psychologist | 1 Sunlit Dr E, Santa Fe, NM 87508-8993 | 2017-11-16 |
| 1164949780 | Christine S. Park | Psychologist | 6020 Constitution Ave Ne Ste 4, Albuquerque, NM 87110-5931 | 2017-08-24 |
| 1982128641 | Krystal Marie Ruiz | Psychologist | 505 S. Main, Ste. 249, Las Cruces, NM 88001 | 2017-08-03 |
| 1700327384 | Anastacia Sena Jaramillo | Psychologist | 126 Silva Ave., Las Vegas, NM 87701 | 2017-03-15 |
| 1477004281 | Ciarra Marrufo | Psychologist | 1100 W Bullock Ave, Artesia, NM 88210-2342 | 2016-10-17 |
| 1346697026 | Mary E. Sawyers, Ma, Lpcc | Psychologist | 1200 N White Sands Blvd Ste 118, Alamogordo, NM 88310-6774 | 2016-05-23 |
| Find all providers with the same taxonomy | ||||
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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.