SHANE PITMAN KELLY (NPI# 1710486832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710486832 |
| Entity Type | Individual |
| Full Name | SHANE PITMAN KELLY |
| Credential | DC |
| Practice Address |
10803 Vista Sorrento Pkwy San Diego CA 92121-2792 |
| Mailing Address |
10803 Vista Sorrento Pkwy Ste 100 San Diego CA 92121-2792 |
| Practice Telephone | 1977730196 |
| Mailing Telephone | 6197773019 |
| Enumeration Date | 2018-02-04 |
| Last Update Date | 2019-08-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC34126 | CA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CHIROPRACTIC LICENSE | DC34126 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528479755 | Shane Kelly | Counselor | 3061 Garden Cir, Unit C, Cameron Park, CA 95682-8557 | 2014-05-09 |
| 1407941552 | Shane M Kelly | Chiropractor | 1445 N Loop West, Suite 120, Houston, TX 77008-1654 | 2006-10-04 |
| 1346695152 | Shane Patrick Kelly | Pharmacist | 839 Farmington Ave, Bristol, CT 06010-3922 | 2016-04-29 |
| Street Address |
10803 VISTA SORRENTO PKWY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-2792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407805344 | Gerino Cinco | Physical Therapist | 10803 Vista Sorrento Pkwy, San Diego, CA 92121-2792 | 2006-05-08 |
| 1962905679 | Kyle Valery | Massage Therapist | 10803 Vista Sorrento Pkwy, San Diego, CA 92121-2792 | 2018-03-09 |
| 1679092878 | Erin Elizabeth Menefee | Physical Therapist | 10803 Vista Sorrento Pkwy, San Diego, CA 92121-2792 | 2017-09-19 |
| 1508382136 | Rose Schlaff | Physical Therapist | 10803 Vista Sorrento Pkwy, San Diego, CA 92121-2792 | 2017-08-15 |
| 1073947263 | Debbie Kay Bright | Chiropractor | 10803 Vista Sorrento Pkwy, San Diego, CA 92121-2792 | 2013-08-24 |
| 1215360599 | Hadar Elbaz | Acupuncturist | 10803 Vista Sorrento Pkwy, San Diego, CA 92121-2792 | 2013-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234286 | Hifai Chiropractic Inc | Chiropractor | 7805 Highland Village Pl Ste 104, San Diego, CA 92129-5181 | 2020-10-28 |
| 1871192922 | Jason Trainer | Chiropractor | 4580 Southampton St, San Diego, CA 92117-4032 | 2020-10-20 |
| 1013548601 | Lianna Hunt | Chiropractor | 4616 Pendleton St, San Diego, CA 92109-3719 | 2020-01-31 |
| 1790328557 | Fillat Chiropractic Inc. | Chiropractor | 10444 Clairemont Mesa Blvd, San Diego, CA 92124-1320 | 2019-10-24 |
| 1710533591 | Shane Kelly, D.c., LLC | Chiropractor | 10803 Vista Sorrento Pkwy Ste 100, San Diego, CA 92121-2792 | 2019-08-16 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1457817835 | Sean Patrick Golden | Chiropractor | 11199 Sorrento Valley Rd Ste 201, San Diego, CA 92121-1334 | 2019-02-11 |
| 1134683766 | Christopher Jepsen | Chiropractor | 9040 Friars Rd # 401, San Diego, CA 92108-5859 | 2019-01-28 |
| 1346725769 | Ruben Alexander Montane | Chiropractor | 3069 Lincoln Ave, San Diego, CA 92104-3030 | 2018-10-02 |
| 1033691241 | Jeffrey Ray Greenlee Jr. | Chiropractor | 2245 Fenton Pkwy Ste 109, San Diego, CA 92108-4737 | 2018-09-04 |
| Find all providers in SAN DIEGO | ||||
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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.