MRS. KELLY MARIE BADURA (NPI# 1730226804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730226804 |
| Entity Type | Individual |
| Full Name | MRS. KELLY MARIE BADURA |
| Credential | PA |
| Practice Address |
8970 Winchester Rd Memphis TN 38125 |
| Mailing Address |
P.o. Box 405827 Atlanta GA 30384-5827 |
| Practice Telephone | 9017945806 |
| Practice Fax Number | 9017947922 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1174 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8970 WINCHESTER RD |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912252354 | Christina B Mccoy | Nurse Practitioner | 8970 Winchester Rd, Memphis, TN 38125-8231 | 2012-07-23 |
| 1750689105 | Heather H Taylor | Nurse Practitioner | 8970 Winchester Rd, Memphis, TN 38125 | 2011-03-09 |
| 1952606055 | Nicole Tabrizi Meredith | Nurse Practitioner | 8970 Winchester Rd, Memphis, TN 38125-8231 | 2011-01-20 |
| 1841526001 | Betsy Adair Cordell | Nurse Practitioner | 8970 Winchester Rd, Memphis, TN 38125-8231 | 2009-10-22 |
| 1306089206 | Baptist Memorial Medical Group Inc | Urology | 8970 Winchester Rd, Memphis, TN 38125-8231 | 2009-04-08 |
| 1356513394 | Fang Zhou | Family Medicine | 8970 Winchester Rd, Memphis, TN 38125 | 2008-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144798448 | Ronald Penn Jr. | Day Training, Developmentally Disabled Services | 4751 Harvest Park Dr., Memphis, TN 38125 | 2018-11-05 |
| 1417458944 | Crestwyn Health Group, LLC | Psychiatry & Neurology | 9485 Crestwyn Hills Cv, Memphis, TN 38125 | 2018-02-21 |
| 1982121323 | Ruthie Rayford | Non-emergency Medical Transport (VAN) | 7244 Grande Bay Cove, Memphis, TN 38125 | 2017-08-25 |
| 1952769119 | Crestwyn Health Group, LLC | Psychiatric Hospital | 9485 Crestwyn Hills Cove, Memphis, TN 38125 | 2016-02-03 |
| 1033590500 | Katherine Brown | Optometrist | 7706 Winchester Road, Suite 105, Memphis, TN 38125 | 2015-06-10 |
| 1073856514 | Quaneshia R Farris | Nurse Practitioner | 7685 Winchester Rd Ste 100, Memphis, TN 38125 | 2013-04-03 |
| 1225379811 | Americare At Southbreeze Assisted Living, LLC | Assisted Living Facility | 3168 Hacks Road Cross, Memphis, TN 38125 | 2013-03-07 |
| 1780934281 | Freds Stores of Tennessee Inc | Pharmacy | 7143 Winchester Rd, Memphis, TN 38125 | 2012-09-12 |
| 1174893598 | Andi Marie Anderson | Nurse Anesthetist, Certified Registered | 3340 Players Club Parkway, Suite 350, Memphis, TN 38125 | 2012-01-02 |
| 1285938266 | Melita Robbins | Behavioral Analyst | 8922 E. Trophy Way, Ste 202, Memphis, TN 38125 | 2011-01-05 |
| Find all providers in zip 38125 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737354 | Adrienne Smith | Physician Assistant | 5200 Park Ave Ste 100, Memphis, TN 38119-3505 | 2020-10-12 |
| 1134734817 | Siushan Tang Vuong | Physician Assistant | 102 Clark Pl Apt S, Memphis, TN 38104-2419 | 2020-09-10 |
| 1174137525 | Gustavo Adolfo Tangarife Sr. | Physician Assistant | 2193 Morning Vista Dr, Memphis, TN 38134-6018 | 2020-09-02 |
| 1053949586 | Michella Glenna Douglas | Physician Assistant | 3911 Oak Branch Cir W, Memphis, TN 38135-0213 | 2020-03-30 |
| 1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
| 1306480868 | Lauren Blum | Physician Assistant | 100 S Greer St, Memphis, TN 38111-3429 | 2019-10-28 |
| 1487135463 | Baron Surgical, Pllc | Physician Assistant | 4728 Spottswood Ave # 199, Memphis, TN 38117-4817 | 2018-08-27 |
| 1083139265 | Huda Alaeddin | Physician Assistant | 6584 Poplar Ave Ste 400, Memphis, TN 38138-3687 | 2017-08-08 |
| 1982076246 | Richard Randolph | Physician Assistant | 1094 River Isle Dr, Memphis, TN 38103-8870 | 2015-10-27 |
| 1962870808 | Sophia Garrison | Physician Assistant | 4562 Poplar Ave Ste 109, Memphis, TN 38117-7515 | 2015-09-09 |
| Find all providers in MEMPHIS | ||||
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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.