DR. KELLY M. MAZZARELLA (NPI# 1770841165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770841165 |
| Entity Type | Individual |
| Full Name | DR. KELLY M. MAZZARELLA |
| Other Name | DR. KELLY M. STONEHAM |
| Credential | D.O. |
| Practice Address |
5323 Harry Hines Blvd Stop 7200 Dallas TX 75390-7200 |
| Mailing Address |
Po Box 845347 Dallas TX 75390-5347 |
| Practice Telephone | 2147305437 |
| Mailing Telephone | 2147305437 |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2020-06-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | S1514 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 221 Third St Bldg 1040, Attn: 359 Mdg/sghq, Jbsa Randolph, TX 78150 | 2106528544 |
| Street Address |
5323 HARRY HINES BLVD STOP 7200 |
| City | DALLAS |
| State | TX |
| Zip Code | 75390-7200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801847991 | Elizabeth Anne Maher | Internal Medicine | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-7208 | 2006-05-13 |
| 1477166429 | Michael Simpson | Audiologist | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-7200 | 2020-08-28 |
| 1851900567 | Anjali Kalra | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-9006 | 2020-07-28 |
| 1225647399 | Chinmayee K Venkatraman | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-7200 | 2020-07-24 |
| 1811506090 | Chelsea Anasi | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-7200 | 2020-07-23 |
| 1750990909 | Anthony Seek | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-9006 | 2020-07-23 |
| 1740899087 | Naomi Mae Cohen | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-9006 | 2020-07-22 |
| 1023626579 | Cameron Thomas Miller | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-7200 | 2020-07-21 |
| 1932717337 | Ruqiya Sheikh-ali | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-7200 | 2020-07-21 |
| 1407464811 | Tyler Douglas Anderson | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-9003 | 2020-07-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467075655 | Richard Mark Bresler | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Mc9159, Dallas, TX 75390 | 2020-05-21 |
| 1356970735 | Fabricio Stewan Feltrin | Student in an Organized Health Care Education/Training Program | 5323 Harry Hynes Boulevard, Dallas, TX 75390 | 2020-04-07 |
| 1477016467 | Seagal Raza Dauglas | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Mc9159, Dallas, TX 75390 | 2019-04-08 |
| 1831674340 | Adwoa Aninkorah | Nurse Practitioner | Ut Southwestern Medical Center 5151 Harry Hines Blvd, Dallas, TX 75390 | 2018-10-01 |
| 1194212712 | Christian Lobue | Clinical Neuropsychologist | 6333 Forest Park Road, 1st Floor, Bla 100, Dallas, TX 75390 | 2018-04-19 |
| 1912439720 | Linsey Lindley | Student in an Organized Health Care Education/Training Program | 5939 Harry Hines Blvd 4th Floor Suite 100, Dallas, TX 75390 | 2017-03-30 |
| 1043759418 | Alyssa Macchiaroli | Registered Nurse | 5323 Harry Hines Blvd Mail Code 8590, Dallas, TX 75390 | 2017-02-18 |
| 1609313980 | Megan Rasmussen Bollner | Physician Assistant | 5303 Harry Hines Blvd Fl 9, Dallas, TX 75390 | 2017-01-25 |
| 1518329168 | Danny Hsu Yang | Hospitalist | 6201 Harry Hines Blved, Dallas, TX 75390 | 2016-03-23 |
| 1780046532 | Omer Mirza | Hospitalist | 6201 Harry Hines Blvd Dallas, Dallas, TX 75390 | 2016-03-22 |
| Find all providers in zip 75390 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982131363 | Julia C Durante | Pediatrics | 2350 N Stemmons Fwy Ste F5200, Dallas, TX 75207-2700 | 2017-05-17 |
| 1891235206 | Jill Whitehurst | Pediatrics | 6436 Glendora Ave, Dallas, TX 75230-5125 | 2017-03-03 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| 1144686601 | Souren Chakmakjian | Pediatrics | 3855 Branchfield Dr, Dallas, TX 75214-2949 | 2016-01-13 |
| 1851756977 | Aaron L. Kreisler, M.d. P.a. | Pediatrics | 1151 N Buckner Blvd # Pb1, Suite 203, Dallas, TX 75218-3426 | 2015-12-16 |
| 1679982540 | Mevelline Lim | Pediatrics | 2350 N Stemmons Fwy Ste 2400, Dallas, TX 75207-2700 | 2014-08-05 |
| 1134549983 | Diana Liz Arriola | Pediatrics | 3434 W Illinois Ave Ste 306-3, Dallas, TX 75211-8709 | 2014-04-20 |
| 1386064269 | Jennifer Nguyen Chew | Pediatrics | 6300 Harry Hines Blvd Ste 101, Dallas, TX 75235-5259 | 2014-04-18 |
| 1215379987 | Colleen D Edge | Pediatrics | 8355 Walnut Hill Ln Ste 105, Dallas, TX 75231-4242 | 2013-07-23 |
| 1083055214 | Richard William Markus | Pediatrics | 7777 Forest Ln Ste B320, Dallas, TX 75230-6820 | 2013-07-16 |
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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.