KELLY RENEE DEATLEY (NPI# 1467848952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467848952 |
| Entity Type | Individual |
| Full Name | KELLY RENEE DEATLEY |
| Other Name | KELLY RENEE MURPHY |
| Credential | M.D. |
| Practice Address |
325 W Walnut St Ste 600 Lebanon KY 40033 |
| Mailing Address |
325 W Walnut St Ste 600 Lebanon KY 40033-1378 |
| Practice Telephone | 2706999500 |
| Practice Fax Number | 2706999550 |
| Mailing Telephone | 2706999500 |
| Mailing Fax Number | 2706999550 |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2018-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 51438 | KY | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | R3750 | KY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100432940 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 215 Central Ave Ste 100, Louisville, KY 402081450 | 5025888720 | 5025888721 |
| 323 E Chestnut St, Suite 518 University of Louisville, Louisville, KY 402021823 | 5028523134 | 5028528866 |
| Street Address |
325 W WALNUT ST STE 600 |
| City | LEBANON |
| State | KY |
| Zip Code | 40033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407400823 | James Elijah Muir | Nurse Practitioner | 325 W Walnut St Ste 600, Lebanon, KY 40033-1378 | 2019-07-25 |
| 1689132128 | Rachael Dobson | Nurse Practitioner | 325 W Walnut St Ste 600, Lebanon, KY 40033-1378 | 2019-03-04 |
| 1154801629 | Anne C Morley | Nurse Practitioner | 325 W Walnut St Ste 600, Lebanon, KY 40033-1378 | 2018-08-15 |
| 1831675651 | Kristen Peterson | Nurse Practitioner | 325 W Walnut St Ste 600, Lebanon, KY 40033-1378 | 2018-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538636311 | One Cross Health Clinic, Inc. | Clinic/Center | 305 Koehler Drive, Lebanon, KY 40033 | 2018-10-30 |
| 1003204892 | Mmhh, LLC | Clinic/Center | 135 E. Martin Luther King Ave., Lebanon, KY 40033 | 2014-12-31 |
| 1194964510 | Gregory W. Schall, Do, Pllc | Family Medicine | 312 W High Street, Lebanon, KY 40033 | 2009-02-09 |
| 1780859553 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 2136 Campbellsville Road, Lebanon, KY 40033 | 2008-04-23 |
| 1144491234 | William Duley IIi | Dentist | 219 West Main St, Lebanon, KY 40033 | 2008-03-17 |
| 1891965927 | Dana Michelle Logsdon | Nurse Practitioner | 727 W. Main St., Lebanon, KY 40033 | 2008-03-05 |
| 1669523684 | The Childrens Clinic, Pllc. | Pediatrics | 420 Loretta Road, Lebanon, KY 40033 | 2007-01-16 |
| 1215022348 | Marion County Anesthesia Associates Pllc | Nurse Anesthetist, Certified Registered | 320 Loretto Road, Lebanon, KY 40033 | 2006-10-04 |
| 1568479426 | Daniel Earl Bailey Jr. | Specialist | 420 Loretto Rd, Suite 600, Lebanon, KY 40033 | 2006-08-02 |
| 1912952458 | Quinton Meek | Psychiatry & Neurology | 65 Old Sprinfield Rd., Lebanon, KY 40033 | 2006-05-23 |
| Find all providers in zip 40033 | ||||
| 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 |
|---|---|---|---|---|
| 1134604606 | Stayton Family Practice Inc | Family Medicine | 41 E Ash St, Lebanon, OR 97355-3317 | 2018-10-01 |
| 1033693031 | Heather Heck | Family Medicine | 1701 Cornwal Road, Lebanon, PA 17042-7480 | 2018-09-17 |
| 1982113148 | A1 Health Care Clinic | Family Medicine | 703 East Main Street, # 8, Lebanon, KY 40444 | 2017-09-20 |
| 1952830127 | Juliana Zamora Cubillos | Family Medicine | 120 Hospital Dr Ste 100, Lebanon, MO 65536-9227 | 2017-06-09 |
| 1245781954 | Mountain States Health Alliance | Family Medicine | 58 Carroll St Suite 3, Dept of Russell County Medical Center, Lebanon, VA 24266 | 2016-10-18 |
| 1982080255 | Dawn Barker | Family Medicine | 331 Hospital Dr Ste C, Lebanon, MO 65536 | 2015-08-10 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1407288210 | Healthsource of Ohio, Inc. | Family Medicine | 1231 Columbus Ave, Unit A 1, Lebanon, OH 45036-8195 | 2013-08-02 |
| 1598108763 | Docare,llc | Family Medicine | 680 E Grant St, Lebanon, OR 97355-4432 | 2013-04-08 |
| 1902148638 | Living Well Integrative Medicine Health Consulting | Family Medicine | 23 Farr Rd, Lebanon, NH 03766-2010 | 2013-03-20 |
| Find all providers in LEBANON | ||||
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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.