RICHARD KELLEY (NPI# 1558316786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558316786 |
| Entity Type | Individual |
| Full Name | RICHARD KELLEY |
| Credential | PA-C |
| Practice Address |
1441 Florida Avenue Modesto CA 95350 |
| Mailing Address |
1441 Florida Ave Ste 200 Modesto CA 95350-4404 |
| Practice Telephone | 2095763609 |
| Mailing Telephone | 2095763601 |
| Mailing Fax Number | 2095763680 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA15710 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | NP13052 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GROUP PTAN GREATER MODESTO MEDICAL SURGICAL ASSOCIATES | CD069A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023176088 | Richard Alan Kelley | Marriage & Family Therapist | 1826 Wili Pa Loop Ste 7, Wailuku, HI 96793-1279 | 2006-12-04 |
| 1376565820 | Richard Dwain Kelley | Emergency Medicine | 13435 N Hwy 183 Ste 311, Austin, TX 78750-3258 | 2006-07-24 |
| 1346882420 | Richard Daniel Kelley | Counselor | 211 4th St, Brookings, SD 57006-1917 | 2019-10-10 |
| 1740344258 | Richard I Kelley | Pediatrics | 707 N Broadway, Baltimore, MD 21205-1832 | 2006-12-20 |
| 1295764744 | Richard Thomas Kelley | Otolaryngology | 750 E Adams St, Syracuse, NY 13210-2306 | 2006-06-30 |
| Street Address |
1441 FLORIDA AVENUE |
| City | MODESTO |
| State | CA |
| Zip Code | 95350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194770651 | Carolyn Joy Di Francesco | Physician Assistant | 1441 Florida Avenue, Modesto, CA 95350 | 2006-05-23 |
| 1033601083 | Edward W. Verde, Md, Inc. | Anesthesiology | 1441 Florida Avenue, Modesto, CA 95350-4418 | 2018-06-05 |
| 1205267242 | Catherine M. Roby, D.o., Inc. | Anesthesiology | 1441 Florida Avenue, Modesto, CA 95350-4405 | 2013-12-02 |
| 1750443305 | Modesto Anesthesia Medical Group | Anesthesiology | 1441 Florida Avenue, Modesto, CA 95350-4405 | 2006-12-13 |
| 1619050846 | Anesthesia Specialists Medical Group,inc | Anesthesiology | 1441 Florida Avenue, Doctors Medical Center, Modesto, CA 95350 | 2006-10-23 |
| 1316032600 | Teresa Ann Vincent | Registered Nurse | 1441 Florida Avenue, Modesto, CA 95350 | 2006-10-04 |
| 1114949922 | Edward W Verde | Anesthesiology | 1441 Florida Avenue, Cardiovascular Anesthesiology, Modesto, CA 95352 | 2006-07-24 |
| 1245256775 | Hwan Y Kim | Anesthesiology | 1441 Florida Avenue, Modesto, CA 95350-4405 | 2006-07-15 |
| 1841231362 | Kent David Tonnemacher | Emergency Medicine | 1441 Florida Avenue, Modesto, CA 95350 | 2006-06-08 |
| 1083654057 | Hoaiminh Nguyen | Physician Assistant | 1441 Florida Avenue, Modesto, CA 95350 | 2006-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
| Find all providers in zip 95350 | ||||
| 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 |
|---|---|---|---|---|
| 1609330109 | Daniel Antonio Villagran-gonzalez | Physician Assistant | 1401 Spanos Ct Ste 130, Modesto, CA 95355-2815 | 2019-01-29 |
| 1255823191 | Laura Lee Ruby Goen | Physician Assistant | 3105 Mchenry Ave Ste 10, Modesto, CA 95350-1439 | 2018-06-06 |
| 1679086755 | Danielle B Deen | Physician Assistant | 1541 Florida Ave Ste 100, Modesto, CA 95350-4438 | 2017-11-10 |
| 1598292724 | Todd Brooks | Physician Assistant | 1800 Coffee Rd Ste 30, Modesto, CA 95355-2700 | 2017-05-18 |
| 1205240660 | David Zarate Rojas | Physician Assistant | 405 Mid Pines Way, Modesto, CA 95354-3378 | 2014-06-13 |
| 1194151704 | Harinder Jhatu | Physician Assistant | 2218 W Whitmore Ave, Modesto, CA 95358-9497 | 2013-09-16 |
| 1902191489 | Heather Marie Clayton-young | Physician Assistant | 3509 Coffee Rd Ste D3, Modesto, CA 95355-1357 | 2011-06-13 |
| 1457553885 | Michael Tannenbaum | Physician Assistant | 1808 Scenic Dr, Apt 107, Modesto, CA 95355 | 2007-06-05 |
| 1013139054 | Bounchanh Trysavath | Physician Assistant | 300 I St, Modesto, CA 95351 | 2007-05-02 |
| 1942378583 | Karen Fields | Physician Assistant | Valley Wound Healing Center, 4335a Nstarway, Modesto, CA 95356 | 2006-12-01 |
| Find all providers in MODESTO | ||||
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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.