DR. KELSEY IDINA SHIDELER (NPI# 1811459837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811459837 |
| Entity Type | Individual |
| Full Name | DR. KELSEY IDINA SHIDELER |
| Credential | MD |
| Practice Address |
747 Broadway Heath Building, 10th Floor Seattle WA 98122 |
| Practice Telephone | 2062154253 |
| Mailing Telephone | 2062154253 |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-06-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | ML60962155 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
747 BROADWAY HEATH BUILDING, 10TH FLOOR |
| City | SEATTLE |
| State | WA |
| Zip Code | 98122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215935960 | Marilee M. Jensen | Registered Nurse | 747 Broadway, Seattle, WA 98122-4379 | 2005-07-07 |
| 1366058919 | Mairghread Foley | Registered Nurse | 747 Broadway, Seattle, WA 98122-4307 | 2020-09-18 |
| 1891301628 | Jessica C Kelley | Registered Nurse | 747 Broadway, Seattle, WA 98122-4307 | 2020-09-17 |
| 1972116010 | Lindsey Gervascio | Registered Nurse | 747 Broadway, Seattle, WA 98122-4379 | 2020-08-28 |
| 1669097572 | Jisun Park | Dietitian, Registered | 747 Broadway, Seattle, WA 98122-4379 | 2020-06-16 |
| 1023633187 | Hang Hoang-nguyen | Pharmacist | 747 Broadway, Seattle, WA 98122-4307 | 2020-06-14 |
| 1558981357 | Caitlin Elizabeth Busbee | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-21 |
| 1164041323 | Emma Ludesi Makoba | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4379 | 2020-04-08 |
| 1043849375 | Kaitlin Jane Byerly | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-07 |
| 1649809161 | Jia Hui Wang | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
| 1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
| 1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
| 1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
| 1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
| 1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
| 1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477181758 | Michael Joseph Skerda | Surgery | 747 Broadway Apt 111, Seattle, WA 98122-4307 | 2020-03-31 |
| 1184185779 | Arezu Hajar Monawer | Surgery | 747 Broadway Bldg 10th, Seattle, WA 98122-4307 | 2019-03-27 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1891248969 | Jad Abou-khalil | Surgery | 1430 Summit Ave, Appt 502, Seattle, WA 98122-3533 | 2016-07-25 |
| 1285016196 | Amer Nassar | Surgery | Department of Surgery Education, University of Washington, Box 356410, Seattle, WA 98195-0001 | 2015-06-27 |
| 1477949857 | Richard Stein | Surgery | 4545 8th Ave Ne, Apt 610, Seattle, WA 98105-5795 | 2015-04-12 |
| 1518353044 | Brian Cook | Surgery | 815 Mercer St. Box 358047, Uw Medicine South Lake Union, Seattle, WA 98109-4325 | 2015-04-10 |
| 1073956058 | Colette S. Inaba | Surgery | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2013-04-09 |
| 1518223122 | Joy Candace Chen | Surgery | 1959 Ne Pacific St Bb-487 Box #356410, Seattle, WA 98195-2462 | 2012-04-09 |
| 1851680102 | Lara Senekjian | Surgery | Po Box 359796, Seattle, WA 98195-9796 | 2011-04-06 |
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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.