KELLY HIDALGO (NPI# 1710046503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710046503 |
| Entity Type | Individual |
| Full Name | KELLY HIDALGO |
| Credential | PT |
| Practice Address |
122 Strother Pl St Simons Island GA 31522-1876 |
| Practice Telephone | 6784636621 |
| Practice Fax Number | 9124667233 |
| Mailing Telephone | 6784636621 |
| Mailing Fax Number | 9124667233 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2017-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 7123 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
7123 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000937087A | 05 | |
| GA | 000937087C | 05 | |
| GA | PHYSICAL THERPAY LICENSE | 7123 | 01 |
| Street Address |
122 STROTHER PL |
| City | ST SIMONS ISLAND |
| State | GA |
| Zip Code | 31522-1876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982186342 | Matthew Mackinnon Gibbs | Specialist/Technologist | 211 Village Dr, St Simons Is, GA 31522 | 2018-09-02 |
| 1770957433 | Jennifer Herrin, Lpc | Community/Behavioral Health | 400 Main Street, Cottage 1, Saint Simons Island, GA 31522 | 2015-11-18 |
| 1508113002 | Ashley Neal Callicutt | Counselor | 301 Sea Island Road, Suite G, St. Simons Island, GA 31522 | 2012-08-14 |
| 1235414103 | Dana D'andrea Duggan | Psychologist | 283 Redfern Village, St. Simons Island, GA 31522 | 2011-10-11 |
| 1528394848 | Nancy Hodges Bowen | Nurse Practitioner | 7000 Wellness Way, Suite 130, St. Simons Island, GA 31522 | 2009-10-21 |
| 1073763215 | John Arthur Hendry | Dentist | 511 Mallery Street, St. Simons Island, GA 31522 | 2008-09-24 |
| 1770775116 | Randolph M. Stevens | Dentist | Coastal Endodontic Associates, 1804 Frederica Rd., Ste B, St. Simons Island, GA 31522 | 2007-08-09 |
| 1689797383 | Angela C Barnard | Nurse Practitioner | 798 Mallery St Apt 2, Saint Simons Island, GA 31522 | 2007-04-09 |
| 1053493486 | Larry D. Daugherty | Dentist | 124 Island Professional Park, St Simons Island, GA 31522 | 2006-10-19 |
| 1134239460 | Joe Neil Garner | Dentist | 288 Redfern Village, St Simons Island, GA 31522 | 2006-08-30 |
| Find all providers in zip 31522 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598379794 | Building Pathways Therapy LLC | Physical Therapist | 2124 Cheshire Bridge Rd Ne Apt 2006, Atlanta, GA 30324-5731 | 2020-09-04 |
| 1679191464 | Pt Mamas, LLC | Physical Therapist | 5660 Lake Forrest Dr, Atlanta, GA 30342-4635 | 2020-07-08 |
| 1336764869 | Outside The Box Pediatric Therapy Solutions | Physical Therapist | 123 Talbot Rd, Savannah, GA 31410-4015 | 2020-06-10 |
| 1215557921 | Carly Cee Witt Gesite | Physical Therapist | 11785 Northfall Ln Ste 501&502, Alpharetta, GA 30009-7971 | 2020-04-22 |
| 1669009627 | Rebecca Grant | Physical Therapist | 5461 Meridian Mark Rd Ste 300, Atlanta, GA 30342-4014 | 2020-03-26 |
| 1508401704 | Danielle Anderson | Physical Therapist | 2146 Thompson Ave Se, Covington, GA 30014-2819 | 2019-11-12 |
| 1124677919 | Therapy Trails of Evans | Physical Therapist | 536 Grand Slam Dr Ste D, Evans, GA 30809-8045 | 2019-09-05 |
| 1043877459 | Hop, Skip & Jump Pediatric Physical Therapy LLC | Physical Therapist | 912 Milledge Rd, Augusta, GA 30904-4455 | 2019-05-21 |
| 1255894366 | Cicely Annette Watson | Physical Therapist | 2620 Satellite Blvd Ste 100, Duluth, GA 30096-1291 | 2019-04-08 |
| 1942772975 | Wee Care Pediatric Therapy, LLC | Physical Therapist | 335 Old Rail Rd, Bloomingdale, GA 31302-4025 | 2019-01-02 |
| Find all providers with the same taxonomy | ||||
| City | ST SIMONS ISLAND |
| Zip Code | 31522 |
Please comment or provide details below to improve the information on KELLY HIDALGO.
| 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.