MICHAEL J KELLY (NPI# 1396766937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396766937 |
| Entity Type | Individual |
| Full Name | MICHAEL J KELLY |
| Credential | MD |
| Practice Address |
1820 W 3rd St Genesis Health Group Davenport IA 52802-1812 |
| Mailing Address |
1820 West Third Street Genesis Health Group Davenport IA 52802-0000 |
| Practice Telephone | 5634210500 |
| Practice Fax Number | 5633261901 |
| Mailing Telephone | 5634210500 |
| Mailing Fax Number | 5633261901 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 24314 | IA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036-079295 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CIGNA | 390808509 | 01 | |
| DEAN HEALTH PLAN | 14313 | 01 | |
| UNITY | 390808509DX | 01 | |
| PHYSICIANS PLUS | 2019320 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389874 | Michael Kelly | Physical Therapist | 1025 Service Pl Ste 200, Vista, CA 92084-7271 | 2020-09-03 |
| 1871949115 | Michael John Kelly | Speech-Language Pathologist | 3484 Fair Oaks Ave, Bowling Green, KY 42104-5529 | 2016-05-05 |
| 1003206004 | Michael Sean Kelly | Nurse Practitioner | 17601 17th St Ste 120, Tustin, CA 92780-1946 | 2015-01-28 |
| 1295135515 | Michael Kelly | Technician, Other | 2215 E 36 1/2 St, Minneapolis, MN 55407-3018 | 2014-08-25 |
| 1225310675 | Michael Thomas Kelly | Pathology | 4156 H Street Rd, Blaine, WA 98230-9228 | 2011-09-12 |
| 1205085073 | Michael H Kelly | Massage Therapist | 76 Bosse Ln, West Seneca, NY 14224-1624 | 2008-09-16 |
| 1275780041 | Michael Foster Kelly | Acupuncturist | 8 Wells Ave, Yonkers, NY 10701-2710 | 2008-08-25 |
| 1346458031 | Michael Francis Kelly | Registered Nurse | 79 Trausneck Pl, Yonkers, NY 10703-1907 | 2007-05-18 |
| 1104045707 | Michael Walter Kelly | Pharmacist | College of Pharmacy, 110 Pharmacy Building, Iowa City, IA 52242-1112 | 2007-04-24 |
| 1710105358 | Michael Kelly | Physical Therapist | 1600 E. Jefferson St., Seattle, WA 98122 | 2007-04-20 |
| Street Address |
1820 W 3RD ST GENESIS HEALTH GROUP |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52802-1812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356347793 | Margaret E Newkirk | Nurse Practitioner | 1820 W 3rd St, Davenport, IA 52802-1812 | 2005-06-21 |
| 1750876751 | Meghan Lynne Grothus | Nurse Practitioner | 1820 W 3rd St, Davenport, IA 52802-1812 | 2018-06-22 |
| 1104336924 | Kelsey Lynn Barger | Physician Assistant | 1820 W 3rd St, Davenport, IA 52802-1812 | 2017-10-06 |
| 1942721584 | Shawna Brit Fury | Nurse Practitioner | 1820 W 3rd St, Davenport, IA 52802-1812 | 2017-07-05 |
| 1528434065 | Quad City Occupational Health | Clinic/Center | 1820 W 3rd St, Davenport, IA 52802-1812 | 2015-08-19 |
| 1518355353 | Stephanie Dittmer | Physical Therapy Assistant | 1820 W 3rd St, Davenport, IA 52802-1812 | 2015-01-01 |
| 1306259767 | Koel Joseph Brooks | Physical Therapist | 1820 W 3rd St, Davenport, IA 52802-1812 | 2014-06-03 |
| 1568899649 | Braaten Health Outpatient Services | Clinic/Center | 1820 W 3rd St, Davenport, IA 52802-1812 | 2013-10-03 |
| 1124454947 | Genesis Health System | Family Medicine | 1820 W 3rd St, Davenport, IA 52802-1812 | 2013-09-25 |
| 1538509443 | Regan A Cone | Family Medicine | 1820 W 3rd St, Davenport, IA 52802-1812 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962042465 | William Albert Childers Jr. | Technician | 1455 W. 8th St., Davenport, IA 52802 | 2020-01-13 |
| 1790293181 | Amy Ruth Allison | Counselor | 1523 S. Fairmount St., Davenport, IA 52802 | 2018-01-19 |
| 1245236942 | Center for Alchol & Drug Services, Inc. | Clinic/Center | 1523 S Fairmount St, Davenport, IA 52802 | 2005-06-27 |
| 1043467269 | Cindy May Hannon | General Acute Care Hospital | 1848 W 7th St, Davenport, IA 52802-1029 | 2008-08-19 |
| 1205063096 | Ryan Bobst | Student in an Organized Health Care Education/Training Program | 1229 W 8th St, Davenport, IA 52802-1331 | 2009-06-18 |
| 1902033673 | Angela C Wells | Social Worker | 1229 W 8th St, Davenport, IA 52802-1331 | 2009-06-19 |
| 1891922563 | Christy A Carter | Social Worker | 1229 W 8th St, Davenport, IA 52802-1331 | 2009-06-19 |
| 1548892359 | Annemarie Irene Chambliss | Counselor | 1202 W 3rd St, Davenport, IA 52802-1344 | 2020-02-10 |
| 1457909103 | Margaret Olin Meloy | Social Worker | 1202 W 3rd St, Davenport, IA 52802-1344 | 2019-08-27 |
| 1629544929 | Rebecca Schroeder | Behavior Technician | 1202 W 3rd St, Davenport, IA 52802-1344 | 2018-10-15 |
| Find all providers in zip 52802 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287831 | Cynthia Marie Silva | Family Medicine | 142 Harrington Ct, Davenport, FL 33837-8986 | 2020-08-27 |
| 1467013565 | Vibrant Health, P.C. | Family Medicine | 1351 W Central Park Ave Ste 1225, Davenport, IA 52804-1889 | 2019-06-28 |
| 1831667062 | Jacqueline Bogle | Family Medicine | 1334 Oakcrest Ct, Davenport, FL 33837-1707 | 2018-11-06 |
| 1427589944 | Aubrey Riefe | Family Medicine | 4317 E 53rd St, Davenport, IA 52807-3860 | 2017-03-26 |
| 1760748644 | Marygold Lora Fernandez | Family Medicine | 2302 North Blvd W Ste D, Davenport, FL 33837-8920 | 2012-04-05 |
| 1184917981 | Linda Malizia Jager | Family Medicine | 1750 E 53rd St, Davenport, IA 52807-2707 | 2011-05-26 |
| 1881908069 | Andrew Michael Teffeau | Family Medicine | 410 Lionel Way Fl 3, Davenport, FL 33837-7809 | 2010-07-30 |
| 1740509280 | Jose Ascension Armendariz | Family Medicine | 4700 E 56th St Ste 300, Davenport, IA 52807-2904 | 2010-05-24 |
| 1336473198 | Simran Jit | Family Medicine | 3411 Spring St, Davenport, IA 52807-2114 | 2009-09-28 |
| 1184870016 | Maria Nina Concepcion Md Pa | Family Medicine | 2302 North Blvd., Suite D, Davenport, FL 33837 | 2008-08-12 |
| Find all providers in DAVENPORT | ||||
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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.