HOLLY R. KELLY (NPI# 1750630786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750630786 |
| Entity Type | Individual |
| Full Name | HOLLY R. KELLY |
| Other Name | HOLLY R. SUCHARETZA |
| Credential | N.P. |
| Practice Address |
211 N Eddy St South Bend IN 46617-2808 |
| Practice Telephone | 5742379231 |
| Practice Fax Number | 5742046355 |
| Mailing Telephone | 5742379231 |
| Mailing Fax Number | 5742046355 |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2014-12-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71004121A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201092360 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689294282 | Holly Suzanne Kelly | Counselor | 2000 S Summit Ave, Sioux Falls, SD 57105-2727 | 2020-04-23 |
| 1053523365 | Holly C Kelly | Case Manager/Care Coordinator | 807 Lawn Avenue, Sellersville, PA 18960 | 2007-05-07 |
| 1639257595 | Holly Jo Kelly | Registered Nurse | 520 N 4th Ave, Pasco, WA 99301-5257 | 2006-11-01 |
| 1619076528 | Holly C Kelly | Specialist | 7100 Redwood Blvd, Suite 200, Novato, CA 94945-4110 | 2006-09-21 |
| Street Address |
211 N EDDY ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073511598 | Ron Clark | Orthopaedic Surgery | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-07-08 |
| 1760082002 | Nicole A Scheidler | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2020-10-27 |
| 1205473451 | Integrative Care Partners LLC | Specialist | 211 N Eddy St, South Bend, IN 46617-2808 | 2019-12-06 |
| 1144882069 | Briana R Weidler-edholm | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-07-01 |
| 1861052029 | Suzanne Marie Holmes | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-06-19 |
| 1609436864 | Philip D Dibert | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-06-19 |
| 1851865174 | Jessica S Evans | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2019-01-21 |
| 1467929570 | Sabrina Jovita Lopez | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2018-10-26 |
| 1326515701 | Kara L Kaiser | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2018-10-24 |
| 1962902254 | Sarah Sue Humes | Registered Nurse | 211 N Eddy St, South Bend, IN 46617 | 2018-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1023429115 | Morning View Assisted Living LLC | Assisted Living Facility | 475 N. Niles Avenue, South Bend, IN 46617 | 2014-05-12 |
| 1265861231 | Rebecca Busenbark | Physical Therapist | 401 E Colfax Ave Ste 102, South Bend, IN 46617 | 2013-11-11 |
| 1962709071 | Doreen Danice Huddleston | Social Worker | 928 East Wayne St, Suit C, South Bend, IN 46617 | 2011-02-25 |
| 1487981734 | Mary Cecilia Roemer | Marriage & Family Therapist | 616 E. Colfax Ave, South Bend, IN 46617 | 2009-11-06 |
| 1225264054 | Sridhar Meda | Dentist | 1005 East Lasalle Ave, South Bend, IN 46617 | 2009-06-08 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437366481 | Michael Reed Johns | Dentist | 103 South Eddy Street, South Bend, IN 46617 | 2007-05-17 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| Find all providers in zip 46617 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417574013 | Hellen Gathesha | Nurse Practitioner | 2123 W Irvington Dr, South Bend, IN 46614 | 2020-06-30 |
| 1073042024 | Emilee Tehrani | Nurse Practitioner | 621 Memorial Dr Ste 512, South Bend, IN 46601-1075 | 2017-06-05 |
| 1952836884 | Ryan Ford | Nurse Practitioner | 2301 N Bendix Dr Ste 500, South Bend, IN 46628-3488 | 2017-04-28 |
| 1124563614 | Alexandrea Burnett | Nurse Practitioner | 211 N. Eddy St., South Bend, IN 46617-3096 | 2016-12-20 |
| 1265700090 | Gregory George Bingaman | Nurse Practitioner | 710 N Niles Ave, South Bend, IN 46617-1924 | 2011-12-07 |
| 1679768774 | Kyra Dee Tatman | Nurse Practitioner | 615 N Michigan St Ste 502, South Bend, IN 46601-1033 | 2007-09-11 |
| 1386686996 | Rhonda Y Griffiths | Nurse Practitioner | 234 Chapin St, Suite I, South Bend, IN 46601-2570 | 2006-06-11 |
| 1083665673 | Beacon Medical Group, Inc. | Nurse Practitioner | 926 Erskine Plz, South Bend, IN 46614-3244 | 2006-05-16 |
| 1699763409 | Patricia Ann Corbett | Nurse Practitioner | 1708 High St, South Bend, IN 46613-2633 | 2005-10-06 |
| 1760082002 | Nicole A Scheidler | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2020-10-27 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
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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.