KELLEY E. BANAGAN (NPI# 1851435408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851435408 |
| Entity Type | Individual |
| Full Name | KELLEY E. BANAGAN |
| Credential | MD |
| Practice Address |
22 S Greene St Suite 11b Baltimore MD 21201-1544 |
| Mailing Address |
920 Elkridge Landing Rd Suite 11b Linthicum MD 21090-2917 |
| Practice Telephone | 4103286040 |
| Mailing Telephone | 4103286040 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2016-08-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
D72819 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
22 S GREENE ST SUITE 11B |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383063 | Malinda Daniel Duke | Nurse Practitioner | 22 S Greene St, Rm N6w84, Baltimore, MD 21201-1544 | 2005-06-01 |
| 1891396784 | Tamara Wiseman | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-11-05 |
| 1063012664 | Shawna Marie Hutton | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-11-01 |
| 1124625413 | Kerry Ann Lambert | Pharmacist | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-08 |
| 1730786104 | Joseph William Russo | Pediatrics | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-07 |
| 1295342327 | Leah Marie Dubose | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-23 |
| 1275147167 | Rosalynn Joy Allen | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-09-08 |
| 1174137269 | Keiara Williams | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1699389858 | Caitlin Lauren Thomas | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1639782568 | Anna Pfouts | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
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| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134767643 | Mohammad Mofreh S Altaleb | Orthopaedic Surgery | 601 North Caroline Street / Rm 5223, Baltimore, MD 21287-0882 | 2019-12-16 |
| 1215956529 | Randy Frank Davis | Orthopaedic Surgery | 3500 Boston St Ste J2, Baltimore, MD 21224-5251 | 2006-07-18 |
| 1376510446 | Benjamin N Carr | Orthopaedic Surgery | 2700 Quarry Lake Dr #300, Baltimore, MD 21209-3746 | 2006-03-07 |
| 1073909461 | Franklin Lee | Orthopaedic Surgery | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2015-04-13 |
| 1134486384 | Amit Jain | Orthopaedic Surgery | 601 N Caroline St, Baltimore, MD 21287 | 2012-04-12 |
| 1144431180 | Clayton L Dean | Orthopaedic Surgery | 301 Saint Paul St, Maryland Spine Center, Baltimore, MD 21202-2102 | 2007-05-24 |
| 1013984673 | John J Carbone | Orthopaedic Surgery | 3001 S Hanover St, Gruehn Bldg, Ste 502, Baltimore, MD 21225-1233 | 2006-03-02 |
| 1215925474 | Mark S Rosenthal | Orthopaedic Surgery | 2700 Quarry Lake Dr, Suite 300, Baltimore, MD 21209-2230 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598273849 | Joint Replacement Cin of Dc LLC | Orthopaedic Surgery | 1 Research Ct Ste 450b, Rockville, MD 20850-3221 | 2018-01-19 |
| 1386152262 | Spine Cin of Dc LLC | Orthopaedic Surgery | 1 Research Ct Ste 450a, Rockville, MD 20850-3221 | 2018-01-13 |
| 1497020960 | Peter Dean Landin | Orthopaedic Surgery | 523 S Washington St, Easton, MD 21601-2826 | 2012-03-17 |
| 1396842324 | Jose Bigol Corvera | Orthopaedic Surgery | 9 Fox Knoll Ct, Timonium, MD 21093-2847 | 2006-09-20 |
| 1023071206 | Said Goto Osman | Orthopaedic Surgery | 1003 W 7th St Ste 503, Frederick, MD 21701-8512 | 2006-04-10 |
| 1194230383 | Advanced Pain Management, LLC | Orthopaedic Surgery | 1050 Key Pkwy Ste 103, Frederick, MD 21702 | 2017-12-10 |
| 1326583006 | Advanced Spine Endoscopy and Pain Institute | Orthopaedic Surgery | 1003 W 7th St Ste 503, Frederick, MD 21701-8512 | 2017-01-04 |
| 1861636458 | Michael Vernon Mills | Orthopaedic Surgery | 8116 Good Luck Rd Ste 200, Lanham, MD 20706-3508 | 2009-04-27 |
| 1437317005 | Ojedapo A. Ojeyemi | Orthopaedic Surgery | 1050 Key Pkwy Ste 103, Frederick, MD 21702-4496 | 2008-05-29 |
| 1992962153 | Antoniades Spine L.L.C. | Orthopaedic Surgery | 615 W Macphail Rd, Suite 210, Bel Air, MD 21014-4309 | 2008-05-16 |
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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.