SCOTT ANDREW KELLY (NPI# 1548891526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548891526 |
| Entity Type | Individual |
| Full Name | SCOTT ANDREW KELLY |
| Credential | SOIDC |
| Practice Address |
242 Avenida Pelayo Unit A San Clemente CA 92672-5033 |
| Practice Telephone | 7734912746 |
| Mailing Telephone | 7734912746 |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356882625 | Scott Kelly | Specialist/Technologist | 21840 Nw 218th Ter, High Springs, FL 32643-9081 | 2017-03-20 |
| 1609998632 | Scott Michael Kelly | Specialist/Technologist | 1701 E Colter St Apt 209, Phoenix, AZ 85016-3374 | 2007-04-03 |
| 1477632396 | Scott S Kelly | Dentist | 116 W John St, Maumee, OH 43537-2145 | 2006-11-02 |
| 1467434357 | Scott Patrick Kelly | Emergency Medicine | Oaklawn Hospital, 200 N. Madison St., Marshall, MI 49068 | 2005-11-16 |
| 1295211001 | Scott Edward Kelly | Social Worker | 707 Ne Couch St, Portland, OR 97232-2922 | 2018-07-15 |
| 1811126105 | Scott Douglas Kelly | Ophthalmology | 2610 S Ih 35, Austin, TX 78704-5703 | 2009-07-07 |
| 1184892051 | Scott A Kelly | Psychologist | 3125 W Main St, Kalamazoo, MI 49006-2997 | 2008-02-13 |
| 1548389166 | Scott Andrew Kelly | Chiropractor | 16902 Southwest Fwy, Suite 100, Sugar Land, TX 77479-2350 | 2007-03-28 |
| 1215088406 | Scott M Kelly | Anesthesiology | 1229 Madison St, Suite 1440, Seattle, WA 98104-3586 | 2007-01-15 |
| 1962508093 | Scott Munro Kelly | Urology | 1004 1st St N, Suite 320, Alabaster, AL 35007-8766 | 2006-09-16 |
| Street Address |
242 AVENIDA PELAYO UNIT A |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92672-5033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355234 | Julie Case | Massage Therapist | 205 Via Presa, I Do Not Work From Home- I Am A Contractor, San Clemente, CA 92672 | 2020-10-30 |
| 1396213971 | Kirtney So Lim | Military Health Care Provider | 62 Area San Mateo Naval Clinic, Camp Pendleton, CA 92672 | 2018-11-13 |
| 1407322258 | Lodie Ikeda | Non-emergency Medical Transport (VAN) | 119 Avenida Dolores B, San Clemente, CA 92672 | 2018-10-19 |
| 1629566245 | I-ting Wang | Counselor | 3551 Camino Mira Costa San Clemente, Suite T, San Clemente, CA 92672 | 2018-04-30 |
| 1174046874 | Russell Thompson Chiropractic Inc | Clinic/Center | 629 Camino De Los Mares, Ste. 104, San Clemente, CA 92672 | 2017-07-25 |
| 1518320415 | Addiction Health Alliance LLC | Clinical Medical Laboratory | 605 Avenida Las Flores, San Clemente, CA 92672 | 2016-03-30 |
| 1871961342 | Paul Van Zeumeren | Marriage & Family Therapist | 2715 Calle Del Comercio, Unit C, San Clemente, CA 92672 | 2015-09-14 |
| 1194043596 | Sima Moayed | Pharmacist | 801 N. Elcamino Real, San Clemente, CA 92672 | 2010-05-10 |
| 1942539432 | Martha Elena Hall | Acupuncturist | 131 W. El Portal, San Clemente, CA 92672 | 2009-12-14 |
| 1922334515 | Katie B Mann | Social Worker | 1401 N. El Camino Real, #100, San Clemente, CA 92672 | 2009-11-02 |
| Find all providers in zip 92672 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194336842 | Jorge Luis Silva | Military Health Care Provider | 118 Sandpiper Ave, San Clemente, CA 92672-5720 | 2020-08-14 |
| 1639793607 | Simon Pedro Trujillo | Military Health Care Provider | 85 Sandpiper Ave, San Clemente, CA 92672-2616 | 2020-06-04 |
| 1386265924 | Salvador Cervantes | Military Health Care Provider | 275 Meadowlark Dr, San Clemente, CA 92672-2618 | 2020-05-06 |
| 1720349871 | Ray Allen Banda | Military Health Care Provider | 644a Puller Pl, San Clemente, CA 92672-2563 | 2012-06-05 |
| 1346538691 | Patrick Brian Quill | Military Health Care Provider | 553a Howard Ln, San Clemente, CA 92672-2556 | 2011-07-20 |
| 1316904097 | Gilbert Ruiz Barrera Jr. | Military Health Care Provider | 314a Smith Ln, San Clemente, CA 92672-2538 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547227 | Landri Acosta | Military Health Care Provider | 5075 Tranquil Way # 102, Oceanside, CA 92057-7870 | 2020-10-29 |
| 1649879537 | David Michael Soliani | Military Health Care Provider | Bld 4101 Stuart Mesa Road, Camp Pendleton, CA 92055-5584 | 2020-10-21 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1770180648 | Darius Lee Sean Woods | Military Health Care Provider | 6033 Sandy Shore Ct, San Diego, CA 92139-1014 | 2020-10-05 |
| 1174130744 | Daniel Carrera | Military Health Care Provider | 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 | 2020-09-28 |
| 1316551740 | Kyle Bode Francis | Military Health Care Provider | 3149 Murray Ridge Rd, San Diego, CA 92123-2917 | 2020-09-02 |
| 1356955918 | Daniel Carr | Military Health Care Provider | 5423 Lake Murray Blvd Apt 7, La Mesa, CA 91942-1551 | 2020-09-01 |
| 1255945069 | Jeremy Lee | Military Health Care Provider | 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 | 2020-08-31 |
| 1639782899 | Tyler Collin Sparks | Military Health Care Provider | 1 Mrb, Camp Pendletion, CA 92055 | 2020-08-27 |
| 1013520667 | Rashaad Brown | Military Health Care Provider | 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 | 2020-08-24 |
| Find all providers with the same taxonomy | ||||
| City | SAN CLEMENTE |
| Zip Code | 92672 |
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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.