KIM MICHELLE KELLY (NPI# 1578585501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578585501 |
Entity Type | Individual |
Full Name | KIM MICHELLE KELLY |
Credential | M.D. |
Practice Address |
12710 Se Division Street Portland OR 97236 |
Mailing Address |
421 Sw Oak St. #210 Portland OR 97204 |
Practice Telephone | 5039883601 |
Mailing Telephone | 5039883663 |
Mailing Fax Number | 5039884098 |
Enumeration Date | 2006-07-25 |
Last Update Date | 2010-03-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 47017 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | DEA # | BK7429930 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992198584 | Kim Marie Kelly | Behavioral Analyst | 20 Tater St, Mont Vernon, NH 03057-1315 | 2015-03-06 |
1851630412 | Kim A Kelly | Counselor | 2528 Oak St, Jacksonville, FL 32204-4504 | 2013-02-01 |
1689950800 | Kim C Kelly | Speech-Language Pathologist | 678 Cantiague Rock Rd, Jericho, NY 11753-1401 | 2011-11-02 |
1538302799 | Kim Darrell Kelly | Naturopath | 1363 Burgundy Rd, Encinitas, CA 92024-1847 | 2009-04-16 |
1740380633 | Kim Erin Kelly | Counselor | 333 S Juniper St, #115, Escondido, CA 92025-4924 | 2006-09-22 |
1790119857 | Kim Marie Kelly | Pharmacist | 1401 Bombing Range Rd, West Richland, WA 99353-8001 | 2013-08-26 |
1730457193 | Kim J Kelly | Counselor | 200 S Pollock St, Selma, NC 27576-3062 | 2011-12-13 |
1457453326 | Kim H Kelly | Registered Nurse | 111 S Front St, Harrisburg, PA 17101-2010 | 2006-09-02 |
Street Address |
12710 SE DIVISION STREET |
City | PORTLAND |
State | OR |
Zip Code | 97236 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
Find all providers in zip 97236 |
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 |
---|---|---|---|---|
1639710783 | Christine Elizabeth O'connor | Family Medicine | 6336 Se 61st Ave, Portland, OR 97206-6718 | 2019-09-30 |
1427608645 | Carehere LLC | Family Medicine | Carehere Clinic- Nasg Portland, Tn, 160 Kirby Drive, Portland, TN 37148 | 2019-09-19 |
1063064285 | Victoria A Deane | Family Medicine | 37 Fall Brook St, Portland, ME 04103-4224 | 2019-07-09 |
1598238214 | Whole Systems Healthcare | Family Medicine | 1020 Sw Taylor St Ste 340, Portland, OR 97205-2508 | 2019-01-04 |
1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
1871943159 | Micah Kiehl | Family Medicine | 4427 Ne Fremont St, Portland, OR 97213-1153 | 2016-06-16 |
1083068589 | Carrie Lynn Binder | Family Medicine | 1035 Nw Northrup St, Portland, OR 97209-3017 | 2016-04-20 |
1437513835 | Kayce A Spear | Family Medicine | 10803 Se Cherry Blossom Drive, Portland, OR 97216-3107 | 2016-04-12 |
1992175509 | Lone Star Evaluations Inc. | Family Medicine | 1500 Wildcat Dr Ste M, Portland, TX 78374-2826 | 2015-09-25 |
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.