MRS. KELLY M DOUB (NPI# 1700179900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700179900 |
| Entity Type | Individual |
| Full Name | MRS. KELLY M DOUB |
| Credential | NNP-BC |
| Practice Address |
2122 Manchester Expressway Columbus GA 31904 |
| Mailing Address |
Po Box 8147 Columbus GA 31908-8147 |
| Practice Telephone | 7063202773 |
| Practice Fax Number | 7065964226 |
| Mailing Telephone | 7063202773 |
| Mailing Fax Number | 7065964226 |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2015-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
RN226465 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
0024169365 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003129046E | 05 | |
| AL | 167215 | 05 |
| Street Address |
2122 MANCHESTER EXPRESSWAY |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891789921 | James H Taff Jr. | Physician Assistant | 2122 Manchester Expressway, Columbus, GA 31904 | 2005-09-05 |
| 1972042281 | Columbus Radiology, LLC | Radiology | 2122 Manchester Expressway, Columbus, GA 31904 | 2017-02-20 |
| 1255568457 | Shaun R. Williams | Anesthesiology | 2122 Manchester Expressway, Columbus, GA 31904-6878 | 2009-06-15 |
| 1083864276 | Warene K Taylor | Nurse Practitioner | 2122 Manchester Expressway, Columbus, GA 31904 | 2008-09-24 |
| 1689834319 | Paul Barringer Gravel | Internal Medicine | 2122 Manchester Expressway, Columbus, GA 31904 | 2008-06-16 |
| 1427235514 | Bryan Patrick Allen | Nurse Practitioner | 2122 Manchester Expressway, Columbus, GA 31904 | 2008-01-30 |
| 1477752863 | Marc R Shaw | Physician Assistant | 2122 Manchester Expressway, Columbus, GA 31904 | 2007-07-16 |
| 1548389885 | St. Francis Hospitalists, LLC | Internal Medicine | 2122 Manchester Expressway, Columbus, GA 31904-6878 | 2007-03-28 |
| 1639272925 | David J Barillo | Plastic Surgery | 2122 Manchester Expressway, Columbus, GA 31904 | 2006-09-06 |
| 1639286834 | Priyumvada M Naik | Internal Medicine | 2122 Manchester Expressway, Columbus, GA 31904 | 2006-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902073968 | Winifred Lea Hix | Nurse Practitioner | 5100 West Broad Street, Columbus, OH 43228 | 2008-05-09 |
| 1871718635 | Peggy Martin O'connor | Nurse Practitioner | Mt Carmel West Hospital, 793 W State St., Columbus, OH 43222-1560 | 2007-04-16 |
| 1164490959 | Alice A Beckman | Nurse Practitioner | 2893 Neil Ave, Apt. 400-b, Columbus, OH 43202-2047 | 2006-03-09 |
| 1922621366 | Lora Zatko | Nurse Practitioner | 700 Childrens Dr, Columbus, OH 43205-2639 | 2020-05-20 |
| 1346861580 | Faith Reger | Nurse Practitioner | 700 Childrens Dr, Columbus, OH 43205-2664 | 2020-04-28 |
| 1770104119 | Jennifer Groves | Nurse Practitioner | 700 Childrens Dr, Columbus, OH 43205-2664 | 2020-04-27 |
| 1215557871 | Kelly Elizabeth Ventresco | Nurse Practitioner | 111 S Grant Ave, Columbus, OH 43215-1898 | 2020-04-23 |
| 1790305324 | Hannah Mcshea | Nurse Practitioner | 700 Childrens Dr, Columbus, OH 43205-2664 | 2020-04-23 |
| 1285254805 | Nicole Warner | Nurse Practitioner | 700 Childrens Dr, Columbus, OH 43205-2664 | 2020-04-23 |
| 1104445469 | Alecia Jean Karr | Nurse Practitioner | 700 Childrens Dr, Columbus, OH 43205-2664 | 2020-04-15 |
| Find all providers in COLUMBUS | ||||
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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.