KELLY MARONEY VINSON (NPI# 1639211089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639211089 |
Entity Type | Individual |
Full Name | KELLY MARONEY VINSON |
Other Name | KELLY ANN MARONEY |
Credential | PA |
Practice Address |
3021 Falling Waters Blvd Suite A Lindenhurst IL 60046-6793 |
Practice Telephone | 8473569300 |
Practice Fax Number | 8473567260 |
Mailing Telephone | 8474360837 |
Mailing Fax Number | 8474360837 |
Enumeration Date | 2007-02-13 |
Last Update Date | 2012-07-18 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982242947 | Kelly Anne Vinson | Physical Therapy Assistant | 1501 Old Shell Rd, Mobile, AL 36604-2226 | 2019-12-20 |
Street Address |
3021 FALLING WATERS BLVD SUITE A |
City | LINDENHURST |
State | IL |
Zip Code | 60046-6793 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386643047 | Christine Kharasch | Family Medicine | 3021 Falling Waters Blvd, Suite A, Lindenhurst, IL 60046-6793 | 2005-07-15 |
1487006482 | Andrew R Prelletz | Physician Assistant | 3021 Falling Waters Blvd, Suite A, Lindenhurst, IL 60046-6745 | 2016-07-01 |
1285067660 | Emilie Brennan | Physician Assistant | 3021 Falling Waters Blvd, Lindenhurst, IL 60046-6745 | 2013-08-20 |
1538431606 | Leia Stephens | Specialist | 3021 Falling Waters Blvd, Ste B, Lindenhurst, IL 60046-6745 | 2012-02-03 |
1497036628 | Heidi J Helgeson Donaubauer | Specialist | 3021 Falling Waters Blvd, Suite C, Lindenhurst, IL 60046-6745 | 2011-09-01 |
1518267673 | Julia Jean Felix | Physician Assistant | 3021 Falling Waters Blvd, Suite A, Lindenhurst, IL 60046-6745 | 2010-10-22 |
1942517776 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 3021 Falling Waters Blvd, Suite C, Lindenhurst, IL 60046-6745 | 2010-08-31 |
1659687150 | Andrew Schaefer | Physical Therapist | 3021 Falling Waters Blvd, Ste C, Lindenhurst, IL 60046-6745 | 2010-08-23 |
1588989057 | North Suburban Physical Therapy, P.C. | Physical Therapist | 3021 Falling Waters Blvd, Lindenhurst, IL 60046-6793 | 2010-03-28 |
1487772208 | Stephen J. Clark M.d.,p.c. | Clinic/Center | 3021 Falling Waters Blvd, Suite A, Lindenhurst, IL 60046-6793 | 2007-03-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962021287 | Kathryn Anne Harper | Physical Therapist | 7900 Rollins Road, Lake Villa, ID 60046 | 2020-04-16 |
1508346263 | Milennium Medical Ltd | Nurse Practitioner | 2866 Falling Waters, Lindenhurst, IL 60046 | 2018-08-21 |
1497264121 | Gail Truger | Speech-Language Pathologist | 24750 W. Dering Lane, Lake Villa, IL 60046 | 2017-09-26 |
1104345669 | Tobias V Schirmer | Speech-Language Pathologist | Palombi Middle School, 133 South Mckinley, Lake Villa, IL 60046 | 2017-09-15 |
1699163410 | Daniel Aron Goldberg | Psychologist | 600 West Grand Avenue, Lake Villa, IL 60046 | 2014-12-31 |
1962838946 | Kendall Barber | Physical Therapist | 50 S Milwaukee Ave Ste 201, Lake Villa, IL 60046 | 2013-09-23 |
1790045284 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 1025 Red Oak Lane, Suite 100, Lindenhurst, IL 60046 | 2012-05-18 |
1548534977 | Daniela Cvetkova | Counselor | 3021 Falling Waters, Lindenhurst, IL 60046 | 2012-03-02 |
1225310568 | Dimitrios George Tsakos | Pharmacist | 399 South Route 45, Lindenhurst, IL 60046 | 2011-09-13 |
1285933085 | Abigail Jean Bradley | Developmental Therapist | 87 Bridlepath Drive, Lindenhurst, IL 60046 | 2011-03-18 |
Find all providers in zip 60046 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023326634 | Heather M Ribaudo | Physician Assistant | 290 Sunrise Hwy, Lindenhurst, NY 11757-2520 | 2010-09-16 |
1497872998 | Anna Maria Cagnina-reilly | Physician Assistant | 291 Sunrise Hwy, Lindenhurst, NY 11757-2518 | 2007-03-22 |
1871635698 | John E Maiorino | Physician Assistant | 290 S Wellwood Ave, Lindenhurst, NY 11757-4903 | 2007-02-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
Find all providers with the same taxonomy |
City | LINDENHURST |
Zip Code | 60046 |
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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.