KELLY AMANDA SMITH (NPI# 1639694276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639694276 |
| Entity Type | Individual |
| Full Name | KELLY AMANDA SMITH |
| Credential | MSN, RN, CPNP-PC/AC |
| Practice Address |
3401 Civic Center Blvd Philadelphia PA 19104-4319 |
| Mailing Address |
2040 Market St Apt 1104 Philadelphia PA 19103-3369 |
| Practice Telephone | 2155901000 |
| Mailing Telephone | 5857390235 |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0222X |
Nurse Practitioner Specialization: Pediatrics, Critical Care |
SP017721 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566371 | Kelly Rae Smith | Nurse Practitioner | 13402 Creekview Rd, Prospect, KY 40059-9028 | 2020-10-22 |
| 1447877899 | Kelly Smith | Dental Hygienist | 7700 Sw Garden Home Rd Apt 24, Portland, OR 97223-7496 | 2020-07-01 |
| 1346720893 | Kelly Smith | Licensed Vocational Nurse | 512 S Kearny, Clarendon, TX 79226 | 2018-08-15 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1013437870 | Kelly Dennis Smith | Public Health or Welfare | 211 Oakmont Dr, New Orleans, LA 70128-3624 | 2017-06-22 |
| 1164955498 | Kelly Ghislaine Smith | Student in an Organized Health Care Education/Training Program | 171 Old Chester Rd, Essex Fells, NJ 07021-1624 | 2017-04-04 |
| 1588026975 | Kelly Therese Smith | Specialist/Technologist | 344 S Maple Ave #2a, Oak Park, IL 60302 | 2016-03-24 |
| 1790168326 | Kelly Smith | Counselor | 545 Sw 26th St, Oklahoma City, OK 73109-6740 | 2015-07-01 |
| 1518353341 | Kelly Smith | Nurse Practitioner | 2232 Wilborn Ave Ste D, South Boston, VA 24592-1662 | 2015-04-08 |
| 1265830491 | Kelly Sue Smith | Speech-Language Pathologist | 210 Starpine Pl Unit A, Prescott, AZ 86303-7017 | 2014-12-22 |
| Street Address |
3401 CIVIC CENTER BLVD |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458463 | Jeffrey R Boris | Pediatrics | 3401 Civic Center Blvd, Children's Hospital of Philadelphia - Cardiology, Philadelphia, PA 19104-4319 | 2005-06-23 |
| 1932700259 | Rukhsar Karim Machiwalla | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-11-03 |
| 1346840519 | Vanessa Leigh Jones | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-27 |
| 1275131849 | Kelsey Ann Maher | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-15 |
| 1437756020 | Jennifer-rose Eccles | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-06 |
| 1891309787 | Morgan Mcmanus | Genetic Counselor, MS | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-08 |
| 1891309456 | Abigail G Stefanides | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-01 |
| 1124631247 | Abrar Khaled Alabdulhadi | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-28 |
| 1003427014 | Terrence Caldwell Jr. | Pharmacist | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-13 |
| 1760093298 | Paige Emily Naschke | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 363LP0222X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013427582 | Lauren Marie Louderback | Nurse Practitioner | 3401 Civic Center Blvd Fl 7, Philadelphia, PA 19104-4319 | 2017-10-10 |
| 1225376437 | Adam Ryan Denson | Nurse Practitioner | 3504 Ainslie St, Philadelphia, PA 19129-1630 | 2013-01-22 |
| 1952688152 | Lauren Leigh Charters | Nurse Practitioner | 3400 Civic Center Blvd # 439, Philadelphia, PA 19104-5127 | 2011-11-16 |
| 1275786964 | Jacqueline Ioli | Nurse Practitioner | 4510 Frankford Avenue, Philadelphia, PA 19124 | 2008-10-28 |
| 1346840519 | Vanessa Leigh Jones | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-27 |
| 1437756020 | Jennifer-rose Eccles | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-06 |
| 1477171825 | Britny Fox | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-07-13 |
| 1053935072 | David J Derosier Jr. | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-06-05 |
| 1487276267 | Erica Addesa | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-05-14 |
| 1952930554 | Danielle Marie Lamarra | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on KELLY AMANDA SMITH.
| 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.