MARK C KELLEY (NPI# 1427004704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427004704 |
Entity Type | Individual |
Full Name | MARK C KELLEY |
Credential | DO |
Practice Address |
1300 Sunset Dr Suite A Grenada MS 38901-4086 |
Practice Telephone | 6622274463 |
Practice Fax Number | 6622265257 |
Mailing Telephone | 6622274463 |
Mailing Fax Number | 6622265257 |
Enumeration Date | 2006-05-26 |
Last Update Date | 2008-04-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | 16693 | MS | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649348194 | Mark A. Kelley | Internal Medicine | 6 Kent Ave, Marshfield, MA 02050 | 2006-12-01 |
1013313154 | Mark Allen Kelley | Registered Nurse | 1818 Albion St, Nashville, TN 37208-2918 | 2014-11-18 |
1003153750 | Mark M Kelley | Nurse Practitioner | 6514 Meadowridge Rd, Elkridge, MD 21075-6115 | 2013-01-14 |
1598998858 | Mark Kelley | Physical Therapy Assistant | 394 N Suncoast Blvd, Ste 40, Crystal River, FL 34429-5466 | 2009-09-02 |
1760645865 | Mark Kelley | Acupuncturist | 209 E Swallow Rd, Fort Collins, CO 80525-2539 | 2008-07-08 |
1902949878 | Mark Andrew Kelley | Marriage & Family Therapist | 405 Westwood Ave, High Point, NC 27262-4325 | 2007-02-14 |
1174622500 | Mark C Kelley | Surgery | 3601 The Vanderbilt Clinic, Nashville, TN 37232-0001 | 2006-09-22 |
1851303978 | Mark A Kelley | Orthopaedic Surgery | 5315 Elliott Dr, Suite 301, Ypsilanti, MI 48197-8634 | 2006-08-13 |
1316980113 | Mark Alan Kelley | Psychiatry & Neurology | 1705 E 19th St, Suite 512, Tulsa, OK 74104-5405 | 2006-06-13 |
1831130996 | Mark Donald Kelley | Nurse Practitioner | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2006-06-09 |
Street Address |
1300 SUNSET DR SUITE A |
City | GRENADA |
State | MS |
Zip Code | 38901-4086 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083613210 | Mal S. Riddell | Family Medicine | 1300 Sunset Dr, Suite B, Grenada, MS 38901-4086 | 2005-07-19 |
1235482340 | Grenada Cardiology LLC | Internal Medicine | 1300 Sunset Dr, Suite W, Grenada, MS 38901-4086 | 2012-10-26 |
1649550708 | Teresa Kaye Pickle | Nurse Practitioner | 1300 Sunset Dr, Ste A, Grenada, MS 38901-4081 | 2011-08-22 |
1164731931 | Latia Monanette Butts | Nurse Practitioner | 1300 Sunset Dr, Ste Q, Grenada, MS 38901-4086 | 2010-09-28 |
1962634170 | Mal S Riddell, D.o. Clinic | Family Medicine | 1300 Sunset Dr, Suite B, Grenada, MS 38901-4086 | 2009-08-20 |
1245462282 | Ralph T Cain | Nurse Practitioner | 1300 Sunset Dr, Ste Q, Grenada, MS 38901-4086 | 2009-08-10 |
1902045735 | Grenada Diagnostic Sleep Center, LLC | Clinic/Center | 1300 Sunset Dr, Suite E, Grenada, MS 38901-4086 | 2009-02-18 |
1225200280 | Charles Edward Hill II | Physical Therapist | 1300 Sunset Dr, Ste G, Grenada, MS 38901-4086 | 2008-03-31 |
1578735791 | Alwin Max Juchheim IIi, Dpm | Podiatrist | 1300 Sunset Dr, Suite P, Grenada, MS 38901-4086 | 2008-03-27 |
1457577074 | John A Marascalco, Md, Pa | Specialist | 1300 Sunset Dr, Suite A, Grenada, MS 38901-4086 | 2007-04-18 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
Find all providers in zip 38901 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568571560 | John A Marascalco | Dermatology | 1300 Sunset Dr, Suite A, Grenada, MS 38901-4086 | 2006-08-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760043046 | Skin In The Game, Pllc | Dermatology | 6510 Highway 90, Gautier, MS 39553-5015 | 2019-06-26 |
1427535079 | Jenna Joe Rose Cooper | Dermatology | 2204 Jefferson Davis Dr, Oxford, MS 38655-5222 | 2018-07-26 |
1427460849 | Anna Allred Wile | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-05-21 |
1134558331 | South Central Clinics, Inc | Dermatology | 920 Matthew Dr Ste 8, Waynesboro, MS 39367-2553 | 2013-11-07 |
1407296825 | Ashley Nicole Emerson | Dermatology | 6510 Highway 90 Ste C, Gautier, MS 39553-5015 | 2013-06-29 |
1265729719 | Jasmine C. Hollinger | Dermatology | 2080 S Frontage Rd Ste 113, Vicksburg, MS 39180-5882 | 2011-07-06 |
1295022861 | Kenneth Daniel Saul | Dermatology | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2011-07-05 |
1689969735 | Adam C Byrd | Dermatology | 313 N Court Ave, Ummc Dermatology - Louisville Clinic, Louisville, MS 39339 | 2011-06-16 |
1063724987 | Lyndsay R Shipp | Dermatology | 705 Sisk Ave Ste 105, Oxford, MS 38655-3413 | 2010-07-08 |
1144545195 | Lisa Renee Chastant | Dermatology | 81 Mdos/sgomd, 301 Fisher St., Keesler Afb, MS 39534-2519 | 2010-04-01 |
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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.