KELLY DAWN BLISS (NPI# 1831334150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831334150 |
| Entity Type | Individual |
| Full Name | KELLY DAWN BLISS |
| Credential | PA |
| Practice Address |
4500 Memorial Dr Belleville IL 62226-5360 |
| Mailing Address |
2100 Powell St Ste 900 Emeryville CA 94608-1844 |
| Practice Telephone | 6182576420 |
| Mailing Telephone | 5108517423 |
| Mailing Fax Number | 5108799120 |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2017-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085003451 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295812477 | Kelly W Bliss | Nurse Practitioner | 1600 E Olive St, Seattle, WA 98122-2735 | 2006-11-01 |
| Street Address |
4500 MEMORIAL DR |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045568 | Kenneth I Bluestone | Anesthesiology | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2005-07-01 |
| 1558979690 | Protestant Memorial Medical Center, Inc. | Clinical Medical Laboratory | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-07-15 |
| 1841815784 | Kayla Marie Tisza | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-16 |
| 1588289581 | Katie O'rourke | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-15 |
| 1518592203 | Daniela Vetan-zlibut | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-03-03 |
| 1396377289 | Kathryn Cook | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-02-07 |
| 1124650353 | Jessica Stricklin | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5399 | 2020-02-05 |
| 1396375788 | Emily Jean Sloan | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-01-24 |
| 1629639695 | Nicholas Raburn | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-06-21 |
| 1124582523 | Jenna Dornak | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528506557 | Amber Alicia Mcclure | Physician Assistant | 1710 Shadow Ridge Ct, Apt F, Belleville, IL 62221-3962 | 2017-02-09 |
| 1639527187 | Wadler Fleurina | Physician Assistant | 11650 Belleville Rd #101, Belleville, MI 48111 | 2016-05-25 |
| 1477971794 | Molly Marie Murray | Physician Assistant | 1 Clara Maass Dr., Belleville, NJ 07109 | 2014-04-03 |
| 1134466485 | Corey A Brooks | Physician Assistant | 180 S 3rd St Ste 104, Belleville, IL 62220-1952 | 2013-01-07 |
| 1497037634 | Melissa Hawkins | Physician Assistant | 1 Clara Mass Drive, Wound Center, Belleville, NJ 07109 | 2011-09-14 |
| 1013070440 | Kim C Wrigley | Physician Assistant | 4700 Memorial Dr Ste 340, Belleville, IL 62226-5373 | 2006-12-18 |
| 1801866462 | Irina Polansky | Physician Assistant | 130 Lincoln Place Ct, Belleville, IL 62221-5884 | 2006-01-25 |
| 1831183334 | Courtney M Mcfarlin | Physician Assistant | 2129 W Main St, Belleville, IL 62226-6666 | 2005-09-12 |
| 1518592203 | Daniela Vetan-zlibut | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-03-03 |
| 1396377289 | Kathryn Cook | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-02-07 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.