KELLY POWELL (NPI# 1417510751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417510751 |
| Entity Type | Individual |
| Full Name | KELLY POWELL |
| Credential | PA |
| Practice Address |
12901 Bruce B Downs Blvd Mdc5 Tampa FL 33612 |
| Mailing Address |
1712 Robert Hill Rd Amory MS 38821-8822 |
| Practice Telephone | 8139743504 |
| Mailing Telephone | 6623158000 |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821442666 | Kelly Powell | Student in an Organized Health Care Education/Training Program | 416 Washington Ave Sw Apt 4, Roanoke, VA 24016-4247 | 2016-04-18 |
| 1184965527 | Kelly M Powell | Audiologist | 3616 Far West Blvd Ste 117-401, Austin, TX 78731 | 2013-03-11 |
| 1356584114 | Kelly Free Powell | Physical Therapist | Cmr 411, Building 700, Rose Barracks, Apo, AE 09112 | 2009-04-09 |
| 1538365317 | Kelly Jo Powell | Occupational Therapy Assistant | 1619 Galleria Club Ln, Apt 203, Charlotte, NC 28270-2529 | 2007-06-27 |
| 1053953968 | Kelly Marie Powell | Counselor | 27w350 High Lake Rd, Winfield, IL 60190-1262 | 2019-10-11 |
| 1659841567 | Kelly Powell | Licensed Practical Nurse | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2018-12-04 |
| 1982085023 | Kelly Powell | Social Worker | 2114 N Franklin Dr, Washington, PA 15301-5891 | 2015-06-15 |
| 1073952842 | Kelly Marie Powell | Social Worker | 3901 Chrysler Dr, Detroit, MI 48201 | 2013-06-14 |
| 1275807851 | Kelly Kristin Powell | Psychologist | 230 S Frontage Rd, New Haven, CT 06519-1124 | 2012-02-29 |
| 1720223605 | Kelly E Powell | Nurse Practitioner | 14100 Fivay Rd, Suite 280, Hudson, FL 34667-7180 | 2008-12-08 |
| Street Address |
12901 BRUCE B DOWNS BLVD MDC5 |
| City | TAMPA |
| State | FL |
| Zip Code | 33612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076799 | Gonzalo Mantilla | Pediatrics | 12901 Bruce B Downs Blvd, Mdc 15, Tampa, FL 33612-4742 | 2005-07-12 |
| 1538796784 | Samia Valeria Ozorio Dutra | Registered Nurse | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-26 |
| 1255966289 | Jessica Huang | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-10 |
| 1487218764 | Chelsea Gebs Black | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612-4742 | 2019-04-23 |
| 1609430925 | Kathryn Elizabeth Rudibaugh | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-23 |
| 1467015883 | Thomas Cole | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-04-22 |
| 1700347283 | Kristopher Johnson | Nurse Practitioner | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2019-03-27 |
| 1366909129 | Derrik Jose Diaz Navarro | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-02-27 |
| 1346717717 | Kyle William Woodward | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2018-10-24 |
| 1982193363 | Nicholas Angelo Mastromarino | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc 30, Tampa, FL 33612-4749 | 2018-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356941504 | Kelsey Alexandra Leon | Physician Assistant | 5033 W Laurel St, Tampa, FL 33607-3855 | 2020-10-27 |
| 1144839796 | Alana Marie Arcese | Physician Assistant | 10401 Villa View Cir, Tampa, FL 33647-2598 | 2020-07-29 |
| 1437768512 | Jessica Lynn Flores-mcgrath | Physician Assistant | 14411 Audubon Trce Apt 912, Tampa, FL 33613-5402 | 2020-07-24 |
| 1417574104 | Hunter Vila | Physician Assistant | 5033 W Laurel St Ste 100, Tampa, FL 33607-3855 | 2020-06-29 |
| 1003432360 | Jennifer Rose Baker Koebert | Physician Assistant | 4001 E Fletcher Ave Fl 6, Tampa, FL 33613-4808 | 2020-06-23 |
| 1487277109 | Victoria Mahi Verzwyvelt | Physician Assistant | 4714 N Habana Ave Apt 510, Tampa, FL 33614-7126 | 2020-05-28 |
| 1538780853 | Lexy Hazle | Physician Assistant | 2715 W Mississippi Ave, Tampa, FL 33629-6131 | 2020-04-27 |
| 1619509494 | Amy Sullinger | Physician Assistant | 207 S Occident St, Tampa, FL 33609-2526 | 2020-02-10 |
| 1225668122 | Michelle Korthauer | Physician Assistant | 1531 W Lemon St Apt 1101, Tampa, FL 33606-1014 | 2020-01-20 |
| 1992344360 | Marisa Ehrlich Berger | Physician Assistant | 311 W Idlewild Ave, Tampa, FL 33604-6656 | 2020-01-02 |
| Find all providers in TAMPA | ||||
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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.