KELLY MARIE NORTH (NPI# 1821177130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821177130 |
| Entity Type | Individual |
| Full Name | KELLY MARIE NORTH |
| Credential | PA-C |
| Practice Address |
260 Township Blvd Ste 20 Camillus NY 13031-1678 |
| Practice Telephone | 3157080091 |
| Practice Fax Number | 3157080194 |
| Mailing Telephone | 3157080091 |
| Mailing Fax Number | 3157080194 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
OA002604 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
MA001686L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4820 W Taft Rd, Suite 108, Liverpool, NY 130882800 | 3154130004 | 3154130827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013400019 | Kelly North | Counselor | 8220 Castor Ave, Philadelphia, PA 19152-2729 | 2018-06-13 |
| 1760783856 | Kelly Ann North | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2010-11-05 |
| Street Address |
260 TOWNSHIP BLVD STE 20 |
| City | CAMILLUS |
| State | NY |
| Zip Code | 13031-1678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518946433 | Margaret Mary Bailey | Specialist | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2006-01-10 |
| 1851535116 | Christine Marie Granato | Internal Medicine | 260 Township Blvd, Suite 20, Camillus, NY 13031-2206 | 2009-04-29 |
| 1689837684 | Qun Xu | Nurse Practitioner | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2008-07-09 |
| 1568652261 | Thomas C Lee | Internal Medicine | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2007-07-28 |
| 1124032032 | Scott A Edison | Internal Medicine | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2006-07-28 |
| 1114931037 | Theodore Koh | Internal Medicine | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2006-07-28 |
| 1205840899 | John Sun | Internal Medicine | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2006-07-28 |
| 1467475715 | John A Dale | Internal Medicine | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2006-07-26 |
| 1720001043 | James G Tifft | Internal Medicine | 260 Township Blvd, Ste 20, Camillus, NY 13031-1674 | 2006-07-26 |
| 1013938174 | Associated Gastroenterologists of Central New York, PC | Internal Medicine | 260 Township Blvd, Ste 20, Camillus, NY 13031 | 2006-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194361337 | Marsha Reedy | Registered Nurse | Baldwinsville Schools, 29 East Oneida Street, Baldwinsville, NY 13031 | 2019-11-22 |
| 1821632167 | Romans Soltani Dentistry, Pllc | Dentist | 5426 W. Genesee Street, Camillus, NY 13031 | 2019-10-30 |
| 1174178859 | Abigail Marie Brunner | Nurse Practitioner | 208 Township Blvd, Suite 100, Camillus, NY 13031 | 2019-08-08 |
| 1649779547 | Claire Isaacson | Counselor | 6000 W Genesee St Ste 400, Camillus, NY 13031 | 2018-02-06 |
| 1811426190 | At Home Independent Living, Inc. | In Home Supportive Care | 4464 Milton Ave, Syracuse, NY 13031 | 2017-06-08 |
| 1548643471 | Podiatry Services of Central New York, PC | Podiatrist | 4912 West Genesee Street, Camillus, NY 13031 | 2015-07-09 |
| 1023497203 | New York Anesthesiology Medical Specialties, PC | Pain Medicine | 5417 West Genesee Street, Suite 1, Camillus, NY 13031 | 2015-05-21 |
| 1194130377 | Costco Wholesale Corporation | Pharmacy | 120 Township Blvd, Camillus, NY 13031 | 2014-06-25 |
| 1487084976 | Todd Ray | Social Worker | 6000 W Genesee St, Camillus, NY 13031 | 2013-11-19 |
| 1093045155 | Rebecca Mae Goal Carroll | Physical Therapist | 5417 W Genesee St, Camillus, NY 13031 | 2010-01-12 |
| Find all providers in zip 13031 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336430131 | John Hyde Alden Jr. | Physician Assistant | 101 Robinhood Ln, Camillus, NY 13031-2310 | 2011-04-27 |
| 1235394388 | Susan Kathy Stuck | Physician Assistant | 5700 W Genesee St Ste 132, Camillus, NY 13031-3212 | 2008-07-28 |
| 1093782542 | Lydia J Anders | Physician Assistant | 5700 W Genesee St, Suite 132, Camillus, NY 13031-3200 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
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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.