ELIZABETH KELLY (NPI# 1609957174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609957174 |
| Entity Type | Individual |
| Full Name | ELIZABETH KELLY |
| Credential | MD |
| Practice Address |
Medical Center Blvd Winston-salem NC 27157-0001 |
| Mailing Address |
Po Box 344 Winston Salem NC 27102-0344 |
| Practice Telephone | 3367162255 |
| Practice Fax Number | 3367165438 |
| Mailing Telephone | 3367162255 |
| Mailing Fax Number | 3367165438 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2010-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 2007-00462 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 9539075 | 01 | |
| NC | MEDCOST | 202033 | 01 |
| NC | BCBS | 146FA | 01 |
| NC | PARTNERS | 810632 | 01 |
| VA | 1609957174 | 05 | |
| NC | 5906823 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992259485 | Elizabeth Kelly | Registered Nurse | 1392 Summit St, Apt C, Columbus, OH 43201-2559 | 2016-08-12 |
| 1528465036 | Elizabeth Kelly | Occupational Therapy Assistant | 10760 Opal St Ne, Circle Pines, MN 55014-1534 | 2014-11-26 |
| 1245659150 | Elizabeth M Kelly | Social Worker | 605 Old White Plains Rd, Second Floor, Tarrytown, NY 10591-5027 | 2014-04-08 |
| 1093130528 | Elizabeth Kelly | Social Worker | 4201 Connecticut Ave. Nw, Suite 300, Washington, DC 20008 | 2014-02-20 |
| 1760743892 | Elizabeth Kelly | Specialist | 879 72nd St, Brooklyn, NY 11228-1051 | 2012-06-05 |
| 1821315144 | Elizabeth Fletcher Kelly | Speech-Language Pathologist | 142 Tamalpais Rd, Fairfax, CA 94930-1501 | 2010-04-26 |
| 1568680312 | Elizabeth Kelly | Registered Nurse | 4925 N Leavitt St, Chicago, IL 60625-1308 | 2007-04-24 |
| 1487601852 | Elizabeth Lepinnet Kelly | Physical Therapist | 51 Elm St, Delhi, NY 13753-1208 | 2006-05-30 |
| 1861458465 | Elizabeth Grey Kelly | Family Medicine | 3712 Wood Rail Dr, Plano, TX 75074-7706 | 2006-04-22 |
| 1831161090 | Elizabeth Ann Kelly | Registered Nurse | 103 Re Jennings Ave Se, P.o. Drawer R, Arlington, GA 39813-8725 | 2006-02-02 |
| Street Address |
MEDICAL CENTER BLVD |
| City | WINSTON-SALEM |
| State | NC |
| Zip Code | 27157-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013365758 | Trevor James Tyner | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston-salem, NC 27103 | 2016-06-02 |
| 1245685866 | Megan Brock | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Wake Forest Baptist Medical Center, Dept of Pediatrics, Winston-salem, NC 27157 | 2016-05-02 |
| 1871961573 | Daniel Smith | Nurse Anesthetist, Certified Registered | Medical Center Blvd, Winston-salem, NC 27157-0001 | 2015-09-11 |
| 1265819692 | Maria-carolina Orbay | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston-salem, NC 27103 | 2015-05-06 |
| 1053707307 | Brent Frederick | Hospitalist | Medical Center Blvd, Winston-salem, NC 27157 | 2015-04-14 |
| 1720491889 | Tiffany Earle | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston-salem, NC 27103 | 2014-06-06 |
| 1881822856 | Christopher James Edwards | Anesthesiology | Medical Center Blvd, Wake Forest University, Baptist Medical Center, Winston-salem, NC 27157 | 2009-06-29 |
| 1245408988 | Archana Manoj Shah | Anesthesiology | Medical Center Blvd, Winston-salem, NC 27157-0001 | 2008-02-15 |
| 1962684514 | Christina Natale Condon | Nurse Practitioner | Medical Center Blvd, Winston-salem, NC 27157-0001 | 2007-12-05 |
| 1790966356 | Hirenkumar Babubhai Patel | Pediatrics | Medical Center Blvd, Winston-salem, NC 27157-1184 | 2007-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255960241 | Alexandra Marie Balmaceda | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Pathology Dept, #1 Medical Center Blvd., Winston-salem, NC 27157 | 2020-04-02 |
| 1164916680 | Jorie Elizabeth Gatts | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Department of Pediatrics, Winston Salem, NC 27157 | 2018-06-18 |
| 1932606555 | Alexi Rae Ellington Webb | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine, Dept of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-04-10 |
| 1851896674 | Wasim Muhammad | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-03-25 |
| 1336643535 | Phillip Martin Kostelic | Student in an Organized Health Care Education/Training Program | Anesthesiology - Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-salem, NC 27157 | 2018-03-21 |
| 1831693324 | Aleah Bond | Student in an Organized Health Care Education/Training Program | Anesthesiology Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-salem, NC 27157 | 2018-03-20 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1023467529 | Edward John Doyle IIi | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Otolaryngology, Watlington Hall 4th Fl. Medical Center Boulevard, Winston-salem, NC 27157 | 2016-06-07 |
| 1477917888 | Jordan Mae Burner | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Office, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-salem, NC 27157 | 2016-04-12 |
| 1174900476 | Kate Elise Winterbottom | Speech-Language Pathologist | 4 Janeway Medical Center Blvd, Hearing and Speech, Winston Salem, NC 27157 | 2015-05-06 |
| Find all providers in zip 27157 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295106110 | Carolina Medicorp Enterprises Inc | Emergency Medicine | 50 W 4th St, Suite 10, Winston-salem, NC 27101-4089 | 2015-10-19 |
| 1417274911 | Lynda Bridges Bialobrzeski | Emergency Medicine | Dept. of Emergency Medicine, Wfu Health Sciences, Medical Center Blvd., Winston-salem, NC 27157 | 2010-04-23 |
| 1366427668 | Daune Angell | Emergency Medicine | 3333 Silas Creek Parway, Emergency Department, Winston-salem, NC 27103 | 2005-12-08 |
| 1174933766 | Stephen Balleh | Emergency Medicine | Medical Center Boulevard, Winston-salem, NC 27157 | 2014-05-05 |
| 1205254513 | Christopher Davis | Emergency Medicine | 1 Medical Center Blvd, Winston-salem, NC 27103 | 2014-04-03 |
| 1255361317 | Mary A Wittler | Emergency Medicine | Medical Center Blvd, Winston-salem, NC 27157-0001 | 2006-07-04 |
| 1588694608 | Manoj Pariyadath | Emergency Medicine | Medical Center Blvd, Winston-salem, NC 27157-0001 | 2006-07-04 |
| 1467496422 | Jonathan D Kelly | Emergency Medicine | Medical Center Blvd, Winston-salem, NC 27157-0001 | 2006-06-16 |
| 1649256983 | Forsyth Emergency Services, P.a. | Emergency Medicine | 3333 Silas Creek Pkwy, Emergency Dept., Winston-salem, NC 27103-3013 | 2005-12-19 |
| 1255317939 | Peter S. Vrooman Jr. | Emergency Medicine | 3333 Silas Creek Pkwy, Emergency Department, Winston-salem, NC 27103-3013 | 2005-12-15 |
| Find all providers in WINSTON-SALEM | ||||
| City | WINSTON-SALEM |
| Zip Code | 27157 |
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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.