KELSEY FERRELL (NPI# 1700311974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700311974 |
| Entity Type | Individual |
| Full Name | KELSEY FERRELL |
| Other Name | KELSEY BRUCH |
| Credential | DO |
| Practice Address |
1793 13th St Se Salem OR 97302 |
| Mailing Address |
1793 13th St Se Salem OR 97302-2541 |
| Practice Telephone | 5033628385 |
| Practice Fax Number | 5033628435 |
| Mailing Telephone | 5033628385 |
| Mailing Fax Number | 5033628435 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2018-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | DO188724 | OR | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | PG182903 | OR | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3600 Nw Samaritan Dr, Corvallis, OR 973303737 | 5417864906 |
| Street Address |
1793 13TH ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215912712 | Amy Gouley | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2005-12-07 |
| 1689275042 | Lindsay Rae Fry | Nurse Practitioner | 1793 13th St Se, Salem, OR 97302-2541 | 2020-11-03 |
| 1265999338 | Brolin Johnson | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2019-02-26 |
| 1023582673 | Anna Delaine Dodd | Nurse Practitioner | 1793 13th St Se, Salem, OR 97302-2541 | 2019-01-16 |
| 1225532211 | Lauren Gene Williams | Nurse Practitioner | 1793 13th St Se, Salem, OR 97302-2541 | 2018-03-22 |
| 1497270268 | Jennifer Robin Smith | Nurse Practitioner | 1793 13th St Se, Salem, OR 97302-2541 | 2017-08-13 |
| 1972048700 | Elizabeth Schmidt | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2017-01-03 |
| 1720436397 | Allison Stoecker | Dermatology | 1793 13th St Se, Salem, OR 97302-2541 | 2016-05-24 |
| 1346610201 | Charity Capuras | Nurse Practitioner | 1793 13th St Se, Salem, OR 97302-2541 | 2015-10-04 |
| 1154700839 | Karsten Johnson | Dermatology | 1793 13th St Se, Salem, OR 97302 | 2015-05-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649354929 | Thomas V Kruse, M.d., P.C. | Dermatology | 1410 Commercial Street Se, Salem, OR 97302-4308 | 2006-10-24 |
| 1003862285 | Thomas V Kruse | Dermatology | 1410 Commercial St Se, Salem, OR 97302 | 2006-05-26 |
| 1598710725 | John Vonweiss M.d. Inc | Dermatology | 107 Highland Ave, Salem, MA 01970-2721 | 2006-05-24 |
| 1831150846 | Dermatology Clinic PC | Dermatology | 2441 Grear St Ne, Salem, OR 97301-2749 | 2006-03-29 |
| 1518959998 | Patricia Reed Tate | Dermatology | 911 N Shelby St, Salem, IN 47167-2304 | 2005-08-22 |
| 1720436397 | Allison Stoecker | Dermatology | 1793 13th St Se, Salem, OR 97302-2541 | 2016-05-24 |
| 1154700839 | Karsten Johnson | Dermatology | 1793 13th St Se, Salem, OR 97302 | 2015-05-27 |
| 1669868493 | Collin Matthew Blattner | Dermatology | 1793 13th St Se, Salem, OR 97302-2541 | 2015-04-08 |
| 1508276023 | Haley Snadecki | Dermatology | 5 Paradise Rd, Salem, MA 01970-4229 | 2014-05-06 |
| 1861812927 | Reyna Dawn Swift | Dermatology | 2441 Grear St Ne, Salem, OR 97301 | 2014-04-16 |
| Find all providers in SALEM | ||||
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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.