MR. TIMOTHY KELLEY (NPI# 1376501395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376501395 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY KELLEY |
| Credential | CRNA |
| Practice Address |
877 Jefferson Ave Memphis TN 38103-2807 |
| Mailing Address |
877 Jefferson Ave Attn: Provider Enrollment Memphis TN 38103-2807 |
| Practice Telephone | 9014485893 |
| Practice Fax Number | 9014485540 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2016-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 10994 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3628056 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134681059 | Timothy Kelley | Durable Medical Equipment & Medical Supplies | 1903 Turner Mccall Blvd Se, Rome, GA 30161-3366 | 2019-04-01 |
| 1710223698 | Timothy Eugene Kelley | Counselor | 313 West Third Street, Suite 204, La Junta, CO 81050 | 2012-12-20 |
| 1356443972 | Timothy Michael Kelley Jr. | Chiropractor | 94 State St, Heuvelton, NY 13654 | 2006-09-03 |
| 1790148245 | Timothy Kelley | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2016-04-01 |
| 1679654057 | Timothy P Kelley | Physician Assistant | 202 Williamson Rd Ste 100, Mooresville, NC 28117-7610 | 2006-10-18 |
| 1871528802 | Timothy Kelley | Otolaryngology | 520 Superior Ave, Ste 270, Newport Beach, CA 92663-3637 | 2006-07-11 |
| 1295788420 | Timothy S. Kelley | Social Worker | 7305 N Military Trl, Va Medical Center, Riviera Beach, FL 33410-7417 | 2006-05-18 |
| Street Address |
877 JEFFERSON AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103-2807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144225590 | Clare L Mccarthy | Emergency Medicine | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2005-06-14 |
| 1508466467 | Ryain Alexander | Nurse Practitioner | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-10-29 |
| 1366049132 | Shruti Elizabeth Anthony | Anesthesiology | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-10-05 |
| 1750998464 | Matthew Porch | Radiologic Technologist | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-09-26 |
| 1851906101 | Stephanie Marie Baggett | Nurse Practitioner | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-09-14 |
| 1275148561 | Suzanne D Moyer | Nurse Practitioner | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-09-13 |
| 1760094999 | Adriann Skeen | Dietitian, Registered | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-08-19 |
| 1578181434 | Erika Gruber | Pharmacist | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-07-08 |
| 1740800267 | Katara Evonne Jackson | Dietitian, Registered | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-04-24 |
| 1891315560 | Emily Ann West | Dietitian, Registered | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505724 | Michelle Lynn Esposito | Dietitian, Registered | 1st Floor Research Center - 50 North Dunlap St, Memphis, TN 38103 | 2020-04-01 |
| 1962030221 | Allison Burge Clayton | Dietitian, Registered | 50 N Dunlap, Nutrition Therapy Dept, 1st Floor Research Tower, Memphis, TN 38103 | 2020-03-31 |
| 1093375420 | Radar Ems, LLC | Social Worker | 50 S. B.b. King Blvd, Suite 350, Memphis, TN 38103 | 2019-06-18 |
| 1528529021 | Denise Andrews Matthews | Nursing Care | 342 Island Dr #105, Memphis, TN 38103 | 2019-03-27 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1194245712 | Cameron Waters Clinard | Optometrist | 127 Isle Creek Dr, Memphis, TN 38103 | 2017-06-24 |
| 1750732582 | Amanda Leigh Eaves | Nurse Practitioner | 364 S Front St Ste 201, Memphis, TN 38103 | 2016-06-22 |
| 1417304569 | John Clark Shell | Family Medicine | 150 Harbor Creek Dr, Memphis, TN 38103 | 2016-05-18 |
| 1750753695 | Tomisha V. Byard | Nurse Practitioner | 718 Habor Bend Road, Memphis, TN 38103 | 2015-10-29 |
| 1053795179 | Melissa Anne Wilkes | Social Worker | 1240 Harbor River Drive, Memphis, TN 38103 | 2015-07-18 |
| Find all providers in zip 38103 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922524073 | Sarah Montgomery Prudhon | Nurse Anesthetist, Certified Registered | 50 N Dunlap St Fl 2, Memphis, TN 38103-2800 | 2017-08-21 |
| 1215469416 | Victoria Peacock | Nurse Anesthetist, Certified Registered | 6455 Poplar Ave, Apt 302, Memphis, TN 38119-4875 | 2017-03-28 |
| 1740733781 | Joshua Donnan | Nurse Anesthetist, Certified Registered | 1068 Cresthaven Rd Ofc, Suite 150, Memphis, TN 38119-0800 | 2016-07-26 |
| 1174893598 | Andi Marie Anderson | Nurse Anesthetist, Certified Registered | 3340 Players Club Parkway, Suite 350, Memphis, TN 38125 | 2012-01-02 |
| 1285901173 | Independent Anesthesia Services | Nurse Anesthetist, Certified Registered | 5179 Gwynne Rd, Memphis, TN 38117-3419 | 2011-11-21 |
| 1922302785 | Daniel L Hester | Nurse Anesthetist, Certified Registered | 1755 Kirby Parkway Suite 330, Memphis, TN 38120 | 2011-01-07 |
| 1699005975 | Robert S Chamblee | Nurse Anesthetist, Certified Registered | 1755 Kirby Pkwy Suite 330, Memphis, TN 38120 | 2010-01-08 |
| 1558528562 | Shannon Bontemps | Nurse Anesthetist, Certified Registered | 111 Harbor Ridge Ln S, Memphis, TN 38103-0843 | 2008-05-19 |
| 1548433485 | Pkanesthesia, Inc | Nurse Anesthetist, Certified Registered | Rt 1 Box 53, Memphis, MO 63555 | 2008-04-11 |
| 1710163092 | Laura E Hartzell | Nurse Anesthetist, Certified Registered | 1755 Kirby Pkwy, Suite 330, Memphis, TN 38120 | 2008-01-16 |
| Find all providers in MEMPHIS | ||||
Please comment or provide details below to improve the information on MR. TIMOTHY 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.