MICHAEL J KELLIS (NPI# 1831190313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831190313 |
| Entity Type | Individual |
| Full Name | MICHAEL J KELLIS |
| Credential | D.O. |
| Practice Address |
150 Seventh Ave Suite 200 Chardon OH 44024-2908 |
| Mailing Address |
Po Box 887 Chardon OH 44024-0887 |
| Practice Telephone | 4402854999 |
| Practice Fax Number | 4402854996 |
| Mailing Telephone | 4402854438 |
| Mailing Fax Number | 4402855870 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2013-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
34004183 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | RR MEDICARE | 250006704 | 01 |
| OH | ANTHEM | 139662 | 01 |
| OH | AETNA | 4073792 | 01 |
| OH | 0658051 | 05 |
| Street Address |
150 SEVENTH AVE SUITE 200 |
| City | CHARDON |
| State | OH |
| Zip Code | 44024-2908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588186720 | Melius Anesthesia LLC | Nurse Anesthetist, Certified Registered | 150 Seventh Ave, Chardon, OH 44024-2908 | 2017-07-10 |
| 1730409400 | Eyebone, LLC | Clinic/Center | 150 Seventh Ave, Chardon, OH 44024-2908 | 2010-06-04 |
| 1194043208 | Tamara Ann Smith | Phlebology | 150 Seventh Ave, Suite 210, Chardon, OH 44024-2908 | 2010-05-13 |
| 1396950184 | Gene Aidan Johnson | Ophthalmology | 150 Seventh Ave, Suite 100, Chardon, OH 44024-2908 | 2007-05-14 |
| 1578681458 | Robert G Chandler | Physical Therapist | 150 Seventh Ave, Suite 200, Chardon, OH 44024 | 2007-03-27 |
| 1427105113 | Heidi F. Baldwin | Nurse Anesthetist, Certified Registered | 150 Seventh Ave, Chardon, OH 44024-2908 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992336770 | Amanda Nicole Nelson | Technician, Other | 133 Up Main St, Chardon, OH 44024 | 2020-01-30 |
| 1679067011 | Janai Marshae Seng | Dentist | 401 South Street #3a, Chardon, OH 44024 | 2018-06-19 |
| 1376036475 | Kasandra Leigh Chapman | Social Worker | 12941 Ravenna Road, Chardon, OH 44024 | 2018-06-13 |
| 1275068652 | Danielle Tilton | Nurse Practitioner | 531 Fifth Ave, Chardon, OH 44024 | 2017-04-24 |
| 1881057040 | Erin Marie Moore | Counselor | 203 Main St., Chardon, OH 44024 | 2016-04-04 |
| 1649689886 | Hope Anne Super | Speech-Language Pathologist | 100 7th Av Suite 255, Chardon, OH 44024 | 2014-08-12 |
| 1740600022 | Elisha Tzvi Fredman | Student in an Organized Health Care Education/Training Program | 13207 Chardon Road, Ravenna, OH 44024 | 2014-04-24 |
| 1083039309 | Jamie Delvecchio | Family Medicine | 150 7th Ave Ste 200, Chardon, OH 44024 | 2014-02-24 |
| 1174947212 | Frank Scarano | Psychologist | 470 Center Street, Chardon, OH 44024 | 2014-02-10 |
| 1659706497 | Jamie Henderson | Physical Therapy Assistant | 9348 South Brown Rd, Chardon, OH 44024 | 2013-09-12 |
| Find all providers in zip 44024 | ||||
| Taxonomy Code | 207RS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Sports Medicine |
| An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043529696 | Sportscare Physicians | Internal Medicine | 2865 N Reynolds Rd Ste 140, Toledo, OH 43615-2069 | 2010-09-30 |
| 1740286673 | Michael Scarpone | Internal Medicine | 3151 Johnson Rd Ste 2, Steubenville, OH 43952-2362 | 2005-06-24 |
| 1154976058 | Sarah Mae Tracey | Internal Medicine | 5680 Venture Dr, Dublin, OH 43017-2190 | 2019-08-07 |
| 1194068072 | Edward Yu Qiao | Internal Medicine | 130 Morris Rd, Circleville, OH 43113 | 2013-03-29 |
| 1548304074 | Promedica Central Physicians, LLC | Internal Medicine | 2865 N Reynolds Rd, Suite 130, Toledo, OH 43615-2068 | 2007-02-17 |
| 1285727552 | Julie M Kerr | Internal Medicine | 1 Perkins Sq, Akron, OH 44308-1063 | 2006-10-01 |
| 1962428557 | Richard So | Internal Medicine | 20800 Westgate Mall, Suite 400, Fairview Park, OH 44126-1323 | 2006-07-15 |
| 1003871575 | Paul J Gubanich | Internal Medicine | 3333 Burnet Ave, Cincinnati, OH 45229-3026 | 2006-04-19 |
| 1063402949 | Henry Albert Stiene | Internal Medicine | 6480 Harrison Ave, Suite 201, Cincinnati, OH 45247-7961 | 2005-10-24 |
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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.