MISS KELLY MICHELE MALLOY (NPI# 1588792097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588792097 |
| Entity Type | Individual |
| Full Name | MISS KELLY MICHELE MALLOY |
| Credential | MD |
| Practice Address |
1500 E Medical Center Dr 1st Floor Taubman Ctr Recp A Ann Arbor MI 48109-5312 |
| Mailing Address |
3621 S State Street 700 Kms Place Ann Arbor MI 48108 |
| Practice Telephone | 7349368051 |
| Mailing Telephone | 7349362047 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 4301089143 | MI | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | MD426319 | PA | Allopathic & Osteopathic Physicians |
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
4301089143 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194239319 | Kelly Ann Malloy | Physical Therapist | 20 W Maple Ave, Merchantville, NJ 08109-5104 | 2017-11-27 |
| 1881088573 | Kelly Malloy | Physical Therapist | 811 W Evergreen Ave, Suite 306, Chicago, IL 60642-2682 | 2015-03-20 |
| 1174864987 | Kelly J Malloy | Pharmacist | 600 Court St, Fulton, MO 65251-1903 | 2013-03-05 |
| 1538448717 | Kelly L Malloy | Day Training/Habilitation Specialist | 1005 Balcom Ln, Trumann, AR 72472-9502 | 2011-08-05 |
| 1740414614 | Kelly Ann Malloy | Occupational Therapy Assistant | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2009-05-07 |
| 1578787073 | Kelly Kathleen Malloy | Obstetrics & Gynecology | 1881 Chicago St, De Pere, WI 54115-3770 | 2007-04-13 |
| 1598773384 | Kelly A Malloy | Optometrist | 1200 W Godfrey Ave, Philadelphia, PA 19141-3323 | 2006-08-04 |
| Street Address |
1500 E MEDICAL CENTER DR 1ST FLOOR TAUBMAN CTR RECP A |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48109-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669475836 | Tami L. Remington | Pharmacist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-0999 | 2005-05-23 |
| 1578164810 | Jessica Leigh Bailey | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-11-03 |
| 1518565910 | Yoshiaki Ota | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-10-16 |
| 1366058356 | Paulo Zupelari Goncalves | Dentist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-09-16 |
| 1306459466 | Jesse P Spalding | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-28 |
| 1992318919 | Batoul Berri | Audiologist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-28 |
| 1063024891 | Nathan Allen Johnson | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-22 |
| 1780296699 | Yoav Hammer | Internal Medicine | 1500 E Medical Center Dr, 2nd Floor, Cardiovascular Center, Ann Arbor, MI 48109-5853 | 2020-08-21 |
| 1891306262 | Sarah Garnai | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-11 |
| 1386254936 | Ryan James Sutherlan | Pharmacist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987024 | Albert Byun | Student in an Organized Health Care Education/Training Program | 1500 E.medical Center Dr., 1h247, Ann Arbor, MI 48109 | 2020-06-22 |
| 1851914931 | Nadine Ibrahim | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Spc 5312, Taubman Center, 1st Floor, Room 1903, Ann Arbor, MI 48109 | 2020-05-22 |
| 1568083350 | Tucker Zimmer | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-03 |
| 1144841099 | Jessica Moore Meves | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-01 |
| 1710522297 | Xiaoyuan Hu | Specialist/Technologist | Obl 2150, 1402 Washington Hts, Ann Arbor, MI 48109 | 2019-11-08 |
| 1376192401 | Regina Kay Freeman | Clinical Nurse Specialist | 4726 Cardiovascular Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 | 2019-09-11 |
| 1477114155 | William Philip Saunders IIi | Student in an Organized Health Care Education/Training Program | 300 N Ingalls Building, Rm Ni4co6, Ann Arbor, MI 48109 | 2019-06-24 |
| 1093290447 | Teresa H Lyden | Speech-Language Pathologist | 1500 E. Medical Center Dr., Spc 5312, 1904 Tc, Otolaryngology-head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1649755091 | Anna Grace Hardenbergh | Speech-Language Pathologist | 1500 E. Medical Center Drive Tc 1904, Otolaryngology Head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
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| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881782308 | Melissa Ann Pynnonen | Otolaryngology | 380 Parkland Plaza, 2nd Floor Suite 210, Ann Arbor, MI 48103-6201 | 2006-10-10 |
| 1902293129 | Hassan Ben Nasser | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2015-04-26 |
| 1922492164 | Andrew Phillip Stein | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2015-03-25 |
| 1144637893 | Natalie S Justicz | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-07-15 |
| 1518370469 | Rosh Kumar Viasha Sethi | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-06-09 |
| 1598175572 | Shannon Flynn Rudy | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-04-30 |
| 1598102881 | Michelle Mizhi Chen | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2013-05-28 |
| 1497190599 | Christopher Michael Welch | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2013-05-02 |
| 1114266426 | Allen Lee Feng | Otolaryngology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2013-02-06 |
| 1801157060 | Andrew Joseph Rosko | Otolaryngology | 1500 East Medical Center Dr, 1st Floor Taubman Center Recp A, Ann Arbor, MI 48109-5312 | 2012-06-05 |
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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.