JOHN PAUL KELLEY (NPI# 1568516060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568516060 |
| Entity Type | Individual |
| Full Name | JOHN PAUL KELLEY |
| Credential | QMHA |
| Practice Address |
709 Nw Everett St Portland OR 97209-3517 |
| Mailing Address |
7916 N Emerald Ave Portland OR 97217-6116 |
| Practice Telephone | 5037377513 |
| Practice Fax Number | 5037377513 |
| Mailing Telephone | 5037377513 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2010-06-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750910436 | John S Kelley | Internal Medicine | 2401 S 31st St # Ms -ag, Temple, TX 76508-0001 | 2020-04-05 |
| 1225415557 | John Christopher Kelley | Psychologist | 8600 Fathom Cir, 2404, Austin, TX 78750-3037 | 2015-05-06 |
| 1770876559 | John P Kelley | Counselor | 4550 E Fifth St, Tucson, AZ 85711 | 2011-05-26 |
| 1437378965 | John M Kelley Jr. | Dentist | 1533 Merrimac Cir, Suite 207, Fort Worth, TX 76107-6571 | 2007-04-24 |
| 1518007467 | John Stewart Kelley | Counselor | 1949 Snowberry Ln, Joplin, MO 64804-5420 | 2007-02-08 |
| 1801942289 | John Roy Kelley Jr. | Dentist | 3733 Southside Blvd, Suites 5 & 6, Jacksonville, FL 32216-4684 | 2007-01-26 |
| 1598869877 | John Paul Kelley | Physical Medicine & Rehabilitation | 7301 East 2nd St, Ste 315, Scottsdale, AZ 85251-5627 | 2006-09-08 |
| 1740229038 | John W Kelley | Internal Medicine | 191 Deep South Farm Rd, Blairsville, GA 30512-2220 | 2006-06-05 |
| 1063414555 | John S Kelley | Obstetrics & Gynecology | 517 Rose St, Las Vegas, NV 89106-4020 | 2005-08-15 |
| 1881259653 | John Paul Kelley Jr. | Physician Assistant | 1130 Annapolis Rd Ste 100, Odenton, MD 21113-1622 | 2019-05-07 |
| Street Address |
709 NW EVERETT ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209-3517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861974081 | Richard Owens | Community Health Worker | 709 Nw Everett St, Portland, OR 97209-3517 | 2018-09-04 |
| 1760843387 | Race Hebrard | Peer Specialist | 709 Nw Everett St, Portland, OR 97209-3517 | 2016-03-09 |
| 1831575679 | Central City Concern Inc | Clinic/Center | 709 Nw Everett St, Portland, OR 97209-3517 | 2015-08-04 |
| 1639560576 | Michael Lawrence Wilson | Counselor | 709 Nw Everett St, Portland, OR 97209-3517 | 2015-02-13 |
| 1053693168 | Jammie Trimble | Case Manager/Care Coordinator | 709 Nw Everett St, Portland, OR 97209-3517 | 2011-09-14 |
| 1194007229 | Dylan Neil Fields | Counselor | 709 Nw Everett St, Portland, OR 97209-3517 | 2011-09-14 |
| 1093018459 | Candia Elliott | Counselor | 709 Nw Everett St, Portland, OR 97209-3517 | 2010-12-07 |
| 1295043479 | Kendra R Castaldo | Counselor | 709 Nw Everett St, Portland, OR 97209-3517 | 2010-09-21 |
| 1316254022 | Shanako Devoll | Counselor | 709 Nw Everett St, Portland, OR 97209-3517 | 2010-09-02 |
| 1245541879 | Alexandra Olson | Case Manager/Care Coordinator | 709 Nw Everett St, Portland, OR 97209-3517 | 2010-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437775558 | John Alan Varner | Case Manager/Care Coordinator | 5833 N Lombard St, Portland, OR 97203-4115 | 2020-06-24 |
| 1750906228 | Dwell Care LLC. | Case Manager/Care Coordinator | 1720 Nw Lovejoy St Ste 202, Portland, OR 97209-2341 | 2020-06-10 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102077 | Joslyn Bailey Gheen | Case Manager/Care Coordinator | 1032 Sw Main St, Portland, OR 97205-2407 | 2019-09-05 |
| 1497311773 | Ali Tareq Ashour | Case Manager/Care Coordinator | 980 Forest Ave Ste 106, Portland, ME 04103-3357 | 2019-05-13 |
| 1427540202 | Amber Tracy Ware | Case Manager/Care Coordinator | 30 Ne Martin Luther King Jr Blvd, Portland, OR 97232-2941 | 2018-06-06 |
| 1710479209 | Katherine Anne Kerr | Case Manager/Care Coordinator | 4307 Ne 102nd Ave, Portland, OR 97220-3439 | 2018-05-31 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1083137459 | David Sague | Case Manager/Care Coordinator | 7820 Ne Holman St Ste B5, Portland, OR 97218-2841 | 2017-07-18 |
| 1538601885 | Gabriela Simone Sargent | Case Manager/Care Coordinator | 4109 Se 113th Ave, Portland, OR 97266-2226 | 2016-11-16 |
| Find all providers in PORTLAND | ||||
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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.