MR. JASON P KELLY (NPI# 1811452378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811452378 |
| Entity Type | Individual |
| Full Name | MR. JASON P KELLY |
| Credential | LMT |
| Practice Address |
709 N Main St North Syracuse NY 13212-1669 |
| Practice Telephone | 3154594549 |
| Mailing Telephone | 3154594549 |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 021332-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | VA PROGRAM | 9286674 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831644251 | Jason Kelly | Spec/Tech, Cardiovascular | 7012 E Nelson Dr, Tucson, AZ 85730-1718 | 2016-08-16 |
| 1861034571 | Jason Lee Kelly | Pharmacist | 100 Walmart Dr, Kingwood, WV 26537-1143 | 2019-10-14 |
| 1598050544 | Jason Kelly | Family Medicine | 9000 Bailey Cove Rd Se, Huntsville, AL 35802-4002 | 2011-06-17 |
| 1669785556 | Jason Kelly | Orthopaedic Surgery | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2010-07-20 |
| 1538399738 | Jason Stuart Kelly | Anesthesiology | 1250 S 18th St, Fernandina Beach, FL 32034-1902 | 2009-07-22 |
| 1346442159 | Jason Matthew Kelly | Pharmacist | 105 Mall Blvd, Monroeville, PA 15146-2230 | 2007-06-04 |
| 1033277876 | Jason Alexander Kelly | Family Medicine | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2006-12-05 |
| 1063590859 | Jason F. Kelly | Radiology | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-11-01 |
| 1073543831 | Jason Kelly | Radiology | 101 E Wood St, Spartanburg, SC 29303-3040 | 2006-07-04 |
| 1659324473 | Jason Kelly | Radiology | 501 E Hampden Ave, Englewood, CO 80113-2702 | 2006-05-19 |
| Street Address |
709 N MAIN ST |
| City | NORTH SYRACUSE |
| State | NY |
| Zip Code | 13212-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387288 | Hannah Inglish | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-10-11 |
| 1437717725 | Olivia Sandford | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-05-31 |
| 1528523164 | Terry Taylor | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-02-07 |
| 1821147190 | Susan Park | Dentist | 709 N Main St, North Syracuse, NY 13212-1669 | 2007-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750845749 | Branches of Growth Mental Health Counseling, Pllc | Counselor | 3709 Brewerton Rd, Syracruse, NY 13212 | 2019-01-24 |
| 1821574070 | Nadia Marie James | Licensed Practical Nurse | 7175 Rose Wood Circle, North Syracuse, NY 13212 | 2018-07-11 |
| 1306364534 | Shonna Jolene Brodhead | Social Worker | Brightpath Counseling, 7266 Buckley Road, North Syracuse, NY 13212 | 2017-09-08 |
| 1477915189 | Karen Filapello | Speech-Language Pathologist | 320 Gateway Park Drive, @ Precision Contractors, N. Syracuse, NY 13212 | 2016-03-22 |
| 1285017095 | Lacey Foster | Skilled Nursing Facility | 5991 East Taft Rd, North Syracuse, NY 13212 | 2015-06-30 |
| 1346500345 | Wahienhawi Hall | Counselor | 7266 Buckley Rd., Bright Path Counseling Center, North Syracuse, NY 13212 | 2012-05-23 |
| 1316253768 | Jenny Barnum | Nurse Practitioner | 5232 Witz Dr, North Syracuse, NY 13212 | 2010-08-24 |
| 1063738797 | Gregory 'greg' Procopio | Registered Nurse | 308 Charlane Parkway, North Syracuse, NY 13212 | 2010-04-20 |
| 1316142243 | Carrie Marie Vincent | Specialist | 401north Main Street, North Syracuse, NY 13212 | 2007-06-20 |
| 1245307594 | Lynda Robin Kreitzer | Podiatrist | 316 South Main Street, North Syracuse, NY 13212 | 2006-11-30 |
| Find all providers in zip 13212 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154724458 | Jami Lee Bisesi | Massage Therapist | 442 S Bay Rd, North Syracuse, NY 13212-3625 | 2014-09-30 |
| 1396387288 | Hannah Inglish | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-10-11 |
| 1437717725 | Olivia Sandford | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-05-31 |
| 1528523164 | Terry Taylor | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-02-07 |
| 1013427632 | Michael J Maresca | Massage Therapist | 5496 E Taft Rd, North Syracuse, NY 13212-3784 | 2017-10-10 |
| 1932619558 | Barbara Jean Arney | Massage Therapist | 5496 E Taft Rd, North Syracuse, NY 13212-3784 | 2017-10-10 |
| 1043737901 | Noelle Pudney | Massage Therapist | 5496 E Taft Rd, North Syracuse, NY 13212-3784 | 2017-08-23 |
| 1497202162 | Lindsay Shelmadine | Massage Therapist | 5496 E Taft Rd, North Syracuse, NY 13212-3784 | 2016-09-09 |
| 1760895528 | David Rose | Massage Therapist | 5496 E Taft Rd, North Syracuse, NY 13212-3784 | 2014-06-09 |
| 1033522800 | Natalie Catania | Massage Therapist | 5496 E Taft Rd, North Syracuse, NY 13212-3784 | 2014-06-09 |
| Find all providers in NORTH SYRACUSE | ||||
| City | NORTH SYRACUSE |
| Zip Code | 13212 |
Please comment or provide details below to improve the information on MR. JASON P KELLY.
| 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.