MAXINE A KELLY (NPI# 1407059140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407059140 |
| Entity Type | Individual |
| Full Name | MAXINE A KELLY |
| Credential | CRNA |
| Practice Address |
1301 2nd Ave Sw Diagnostic Clinic Largo FL 33770-3120 |
| Practice Telephone | 7275818767 |
| Practice Fax Number | 7275017321 |
| Mailing Telephone | 7275818767 |
| Mailing Fax Number | 7275017321 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2011-02-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | ARNP181174 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | 430016112 | 01 |
| Street Address |
1301 2ND AVE SW DIAGNOSTIC CLINIC |
| City | LARGO |
| State | FL |
| Zip Code | 33770-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851314 | Diagnostic Clinic Medical Group Inc. | Allergy & Immunology | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2005-06-16 |
| 1952924979 | Jordan Ashley Bennett | Advanced Practice Midwife | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2020-05-26 |
| 1205477072 | Calli Keenan Fodor | Audiologist | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2019-10-03 |
| 1093283145 | Patricia Hanratty | Nurse Practitioner | 1301 2nd Ave Sw, Largo, FL 33770-2298 | 2018-11-07 |
| 1649786781 | Erica Anne Martin | Physician Assistant | 1301 2nd Ave Sw, Largo, FL 33770-2298 | 2017-12-27 |
| 1144736927 | Mladen Nikolic | Nurse Practitioner | 1301 2nd Ave Sw, Largo, FL 33770 | 2017-12-15 |
| 1922524958 | Kimmy Nhut Nguyen | Physician Assistant | 1301 2nd Ave Sw, Largo, FL 33770 | 2017-08-22 |
| 1164959920 | Orthopaedic Associates of West Florida, Pa | Clinic/Center | 1301 2nd Ave Sw, Fl 6, Largo, FL 33770-3120 | 2017-05-11 |
| 1932644580 | Janet A Mccormick | Nurse Practitioner | 1301 2nd Ave Sw, Largo, FL 33770-2298 | 2017-01-05 |
| 1619323417 | Optic Shoppe Dme | Durable Medical Equipment & Medical Supplies | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2016-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467005041 | Chelsey Lyn Shepos | Optometrist | 1030 West Bay Dr, Suite 200, Largo, FL 33770 | 2019-07-22 |
| 1407353626 | Michael E Ibrahim | Pharmacist | 1290 West Bay Drive, Largo, FL 33770 | 2018-04-13 |
| 1518413384 | Payton Kuhlenbeck | Anesthesiology | 210 14th Street Sw, Largo, FL 33770 | 2016-08-31 |
| 1639536865 | Ryan Boice | Physical Therapy Assistant | 118 West Bay Drive, Suite 111, Largo, FL 33770 | 2016-01-19 |
| 1508238858 | Alignment Healthcare Florida LLC | Clinic/Center | 1301 2nd Ave., Sw, Largo, FL 33770 | 2015-10-27 |
| 1891161808 | Jessica Nicole Mcglone | Nurse Practitioner | 601 Rosery Rd Ne Apt 1502, Largo, FL 33770 | 2015-08-12 |
| 1033598602 | Demetria Anderson | Counselor | 1301 Seminole Blvd Ste 103, Largo, FL 33770 | 2015-05-28 |
| 1962881821 | Building Blocks Therapy, Pllc | Community/Behavioral Health | 1301 Seminole Blvd Building A Suite 103, Largo, FL 33770 | 2015-05-26 |
| 1457765968 | Summer Moon | Dermatology | 115 Highland Ave N, Largo, FL 33770 | 2014-06-12 |
| 1578982393 | Lauren Elizabeth Grandpre | Emergency Medicine | 201 14th St. Sw, Largo Medical Center Emergency Department, Largo, FL 33770 | 2014-04-09 |
| Find all providers in zip 33770 | ||||
| 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 |
|---|---|---|---|---|
| 1619274107 | Advanced Anesthesia of The West Coast LLC | Nurse Anesthetist, Certified Registered | 7300 Bryan Dairy Rd Ste 495, Largo, FL 33777-1544 | 2011-02-17 |
| 1790868354 | Therese Ann Conner | Nurse Anesthetist, Certified Registered | 10761 125th Ave, Largo, FL 33778-2712 | 2006-10-24 |
| 1508834771 | Kathryn Andolina | Nurse Anesthetist, Certified Registered | 7300 Bryan Dairy Rd, Anesthesia Dept, Largo, FL 33777-1534 | 2006-03-14 |
| 1457981854 | Tiffany Coulter | Nurse Anesthetist, Certified Registered | 201 14th St Sw, Largo, FL 33770-3133 | 2020-01-24 |
| 1770045551 | Compassionate Anesthesia Care LLC | Nurse Anesthetist, Certified Registered | 7300 Bryan Dairy Rd Ste 495, Largo, FL 33777-1544 | 2019-04-02 |
| 1245727080 | Cody Wallace Aucoin | Nurse Anesthetist, Certified Registered | 201 14th St Sw, Largo, FL 33770 | 2018-04-17 |
| 1538347422 | Marcos S Faltamo Crna PC | Nurse Anesthetist, Certified Registered | 1300 Mercantile Ln, Largo, MD 20774-5327 | 2008-02-04 |
| 1871619684 | Dori Jakubek Weigel | Nurse Anesthetist, Certified Registered | 2025 Indian Rocks Rd S, Largo, FL 33774-1035 | 2007-03-22 |
| 1508884867 | Angela Faye Baldwin | Nurse Anesthetist, Certified Registered | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2006-07-17 |
| 1750319141 | Donald S. Moyer | Nurse Anesthetist, Certified Registered | 1551 W Bay Dr, Largo, FL 33770-2209 | 2006-06-28 |
| Find all providers in LARGO | ||||
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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.