NEIL R KELLEY (NPI# 1437184025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437184025 |
| Entity Type | Individual |
| Full Name | NEIL R KELLEY |
| Credential | DPM |
| Practice Address |
1730 Main St Fortuna CA 95540-2451 |
| Practice Telephone | 7077255223 |
| Practice Fax Number | 7077252756 |
| Mailing Telephone | 7077255223 |
| Mailing Fax Number | 7077252756 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2014-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 000E23210 | CA | Podiatric Medicine & Surgery Service Providers |
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
000E23210 | CA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
000E23210 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GRE001770 | 05 | |
| CA | BLUE CROSS | 201857499 | 01 |
| CA | BLUE SHIELD | ZZZ64278Z | 01 |
| Street Address |
1730 MAIN ST |
| City | FORTUNA |
| State | CA |
| Zip Code | 95540-2451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508422015 | Humboldt Foot & Ankle PC | Podiatrist | 1730 Main St, Fortuna, CA 95540-2467 | 2019-05-10 |
| 1073783163 | Brett Michael Wonenberg | Dentist | 1730 Main St, Suite A, Fortuna, CA 95540-2451 | 2008-03-05 |
| 1851590012 | Ali Deyhim | Podiatrist | 1730 Main St, Fortuna, CA 95540 | 2007-07-17 |
| 1154452324 | Kerisa Sue Elloway | Dentist | 1730 Main St, Suite A, Fortuna, CA 95540-2451 | 2007-03-08 |
| 1003986779 | Family Foot Care Specialist Podiatry Center | Durable Medical Equipment & Medical Supplies | 1730 Main St, Fortuna, CA 95540-2451 | 2006-11-09 |
| 1699791160 | Family Foot Care Specialists Podiatry Center Inc | Durable Medical Equipment & Medical Supplies | 1730 Main St, Fortuna, CA 95540-2467 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234787 | Remi Vista, Inc. | Community/Behavioral Health | 3000 Newburg, Fortuna, CA 95540 | 2020-01-21 |
| 1144867474 | Paula-marie Schneider | Registered Nurse | 3750 Rohnerville Rd., Fortuna, CA 95540 | 2019-12-05 |
| 1609265537 | Nancy Stinson Lollich | Physical Therapy Assistant | 2321 Newburg Road, Fortuna Rehabilitation and Wellness, Fortuna, CA 95540 | 2015-01-15 |
| 1730438151 | Heber House Inc. Dba Dermatology Center | Dermatology | 2404 Newburg Rd., Fortuna, CA 95540 | 2012-08-30 |
| 1104173418 | Michelle Leigh Hoopes | Physician Assistant | 3304 Renner Dr Suite B, Fortuna, CA 95540 | 2012-08-07 |
| 1205181526 | Constance Mitchell | Registered Nurse | Redwood Pediatrics, 3305 Renner Dr, Fortuna, CA 95540 | 2012-07-24 |
| 1730457177 | Joy Nadine Frasier | Counselor | 220 Wilson Ln., Fortuna, CA 95540 | 2011-12-13 |
| 1063791713 | Gardenside Eldercare, LLC | Residential Treatment Facility, Physical Disabilities | 529 9th Street, Fortuna, CA 95540 | 2011-08-12 |
| 1093025173 | Sheri A Jewett | Massage Therapist | 2655 Virginia Court, Fortuna, CA 95540 | 2010-10-07 |
| 1134371339 | Mariana Van Der Merwe | Pharmacist | 725 South Boulevard, Rite Aid Pharmacy, Fortuna, CA 95540 | 2008-10-21 |
| Find all providers in zip 95540 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884610 | South Bay Foot & Ankle Specialists, Inc. | Podiatrist | 5565 Grossmont Center Dr Ste 510, La Mesa, CA 91942-3024 | 2020-09-07 |
| 1811512866 | Ankle & Foot Care Center Inc | Podiatrist | 15141 Whittier Blvd Ste 330, Whittier, CA 90603-2168 | 2020-06-15 |
| 1912528928 | Clement Podiatry PC | Podiatrist | 505 Sansome St Ste 850, San Francisco, CA 94111-3114 | 2020-04-30 |
| 1942834775 | Felix Sigal Dpm A Professional Corporation | Podiatrist | 201 S Alvarado St Ste 819, Los Angeles, CA 90057-2391 | 2020-03-02 |
| 1033758339 | Yosemite Bone and Joint Inc | Podiatrist | 1199 Delbon Ave Ste 1, Turlock, CA 95382-2006 | 2020-01-03 |
| 1194361634 | K David Flora Dpm Inc | Podiatrist | 1086 N Cherry St, Tulare, CA 93274-2251 | 2019-11-19 |
| 1902457963 | Silverlake Virgil Surgery Center | Podiatrist | 3367 W 1st St Ste 204, Los Angeles, CA 90004-6080 | 2019-09-21 |
| 1134778178 | Mohamad Belal Sharif | Podiatrist | Va Loma Linda 11201 Benton St, Loma Linda, CA 92357-0001 | 2019-09-11 |
| 1972159366 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 6061 N 1st St Ste 103, Fresno, CA 93710-5470 | 2019-08-13 |
| 1790331189 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 774 N Prospect St Ste B, Porterville, CA 93257-1941 | 2019-08-13 |
| Find all providers with the same taxonomy | ||||
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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.