DR. AMY MARIE KELLY (NPI# 1588645121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588645121 |
| Entity Type | Individual |
| Full Name | DR. AMY MARIE KELLY |
| Credential | M.D. |
| Practice Address |
2004 Randolph Ave #4112 Saint Paul MN 55105-1750 |
| Mailing Address |
2247 Sargent Ave Saint Paul MN 55105-1157 |
| Practice Telephone | 6516906714 |
| Practice Fax Number | 6516906188 |
| Mailing Telephone | 6516999555 |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
40727 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578173555 | Amy Kelly | Nurse Practitioner | 115 N Sumter St Ste 300, Sumter, SC 29150-4967 | 2020-08-05 |
| 1508349226 | Amy Kelly | Speech-Language Pathologist | 509 Wyoming Ave, Audubon, NJ 08106-1631 | 2018-09-09 |
| 1770082018 | Amy Danielle Kelly | Case Manager/Care Coordinator | 11667 Charest St, Hamtramck, MI 48212-3026 | 2018-02-01 |
| 1598126724 | Amy B Kelly | Speech-Language Pathologist | 2650 Ridge, Northshore University Healthsystem, Evanston, IL 60201 | 2016-03-16 |
| 1225469208 | Amy Kelly | Marriage & Family Therapist | 67 E Madison St # 1421, Chicago, IL 60603 | 2013-12-02 |
| 1841594645 | Amy Beth Kelly | Social Worker | 2 Easterly Ave, Suite 1, Auburn, NY 13021-3778 | 2011-01-07 |
| 1336463785 | Amy J Kelly | Registered Nurse | 555 Midtowne St Ne Ste 450, Grand Rapids, MI 49503-5732 | 2010-03-15 |
| 1801047972 | Amy Kelly | Counselor | 713 Chestnut Street Counseling, 713 Chestnut St, Manchester, NH 03104 | 2008-10-07 |
| 1477765592 | Amy Elizabeth Kelly | Occupational Therapist | 8650 Governor's Hill Drive, Suite 180, Cincinnati, OH 45242 | 2007-05-03 |
| 1518901164 | Amy E Kelly | Dietitian, Registered | 3301 Harden Street 5 Medical Park, Palmetto Health Richland, Columbia, SC 29203 | 2006-06-15 |
| Street Address |
2004 RANDOLPH AVE #4112 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55105-1750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700874781 | Barbara Ann Thomas | Nurse Practitioner | 2004 Randolph Ave, #4112, Saint Paul, MN 55105-1750 | 2005-10-12 |
| 1891016481 | St Catherine University | Pediatrics | 2004 Randolph Ave, Mail #4112, Saint Paul, MN 55105-1750 | 2010-06-17 |
| 1376638221 | Abby Emma Marie Edgar | Specialist/Technologist | 2004 Randolph Ave, F-18, Saint Paul, MN 55105-1750 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704020 | Grand Avenue Smiles | Dentist | 1845 Grand Avenue, St. Paul, MN 55105 | 2019-08-09 |
| 1205304839 | Michelle Marie Loken Price | Acupuncturist | 877 Lincoln Ave, Saint Paul, MN 55105 | 2018-11-13 |
| 1326566936 | Becky Lynn Lawyer | Counselor | 1704 Palace Ave, St Paul, MN 55105 | 2017-09-04 |
| 1679020226 | Internal Revolution Counseling and Consulting, L.L.C. | Psychologist | 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 | 2016-09-01 |
| 1487059689 | Jennifer Mason | Lactation Consultant, Non-RN | 1382 Summit Ave, Saint Paul, MN 55105 | 2014-10-30 |
| 1679818850 | Marc Lane Wolfson | Registered Nurse | 1148 Grand Avenue, St. Paul, MN 55105 | 2012-11-29 |
| 1457602781 | Charting Your Success | Social Worker | 2050 St Clair Avenue, Suite 1e, St Paul, MN 55105 | 2012-09-26 |
| 1871867549 | Stacia Hanson Ma Lp LLC | Psychologist | 889 Grand Avenue, Suite 203, St Paul, MN 55105 | 2012-02-28 |
| 1265718142 | Caitlin Marie Young | Midwife | 968 Grand Ave., St. Paul, MN 55105 | 2011-10-24 |
| 1659512622 | Wellness Cooperative LLC | Chiropractor | 976 Grand Ave., St. Paul, MN 55105 | 2009-03-20 |
| Find all providers in zip 55105 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952473662 | Julia Ann Beckman | Pediatrics | 1547 Livingston Ave, Saint Paul, MN 55118-3411 | 2006-11-15 |
| 1891016481 | St Catherine University | Pediatrics | 2004 Randolph Ave, Mail #4112, Saint Paul, MN 55105-1750 | 2010-06-17 |
| 1184796898 | Pediatric & Adolescent Care of Mn., P.a. | Pediatrics | 1547 Livingston Ave, Saint Paul, MN 55118-3411 | 2006-11-15 |
| 1184796856 | James Alan Hocks | Pediatrics | 1547 Livingston Ave, Saint Paul, MN 55118-3411 | 2006-11-15 |
| 1376615070 | Luis Vilaseca | Pediatrics | 1547 Livingston Ave, Saint Paul, MN 55118-3411 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275657348 | James Lee Anderson | Pediatrics | 707 Ridgewood Rd, Duluth, MN 55804-1732 | 2007-03-16 |
| 1912069519 | Northern Lights Pediatric & Adolescent Medicine | Pediatrics | 3555 Willow Lake Blvd., Suite 140, Vadnais Heights, MN 55110-4462 | 2006-12-14 |
| 1841221892 | Federico Pascual Tinsay | Pediatrics | 15765 Holstein Avenue, Redlake, MN 56671-0497 | 2006-07-06 |
| 1508850561 | Linda J Knapp | Pediatrics | 3555 Willow Lk Blvd, Suite 140, Vadnais Heights, MN 55110 | 2005-09-07 |
| 1669996278 | Leander Dominic Timothy | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-07-26 |
| 1376775437 | Lisa Ann Bishop | Pediatrics | 15245 Bluebird St Nw, Andover, MN 55304 | 2009-08-21 |
| 1194975110 | Roy F House | Pediatrics | 200 1st St Sw, Emeritus Staff Center Plummer North 10, Rochester, MN 55905-0001 | 2008-09-26 |
| 1114007705 | James Michael Marquardt | Pediatrics | 3585 Lexington Avenue North, Suite 350, Shoreview, MN 55126-8056 | 2006-10-17 |
| 1922197854 | Anne M Kelly | Pediatrics | 516 Delaware Street, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455 | 2006-10-11 |
| 1659395283 | Douglas Tate | Pediatrics | 6545 France Ave S, Suite 400, Edina, MN 55435-2131 | 2006-07-27 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55105 |
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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.