KELLY O SMITH (NPI# 1851689467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851689467 |
| Entity Type | Individual |
| Full Name | KELLY O SMITH |
| Credential | PA |
| Practice Address |
47 Jolley Dr Bloomfield CT 06002-3092 |
| Practice Telephone | 8602433020 |
| Practice Fax Number | 8602433002 |
| Mailing Telephone | 8602433020 |
| Mailing Fax Number | 8602433002 |
| Enumeration Date | 2011-07-16 |
| Last Update Date | 2017-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 002588 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566371 | Kelly Rae Smith | Nurse Practitioner | 13402 Creekview Rd, Prospect, KY 40059-9028 | 2020-10-22 |
| 1447877899 | Kelly Smith | Dental Hygienist | 7700 Sw Garden Home Rd Apt 24, Portland, OR 97223-7496 | 2020-07-01 |
| 1346720893 | Kelly Smith | Licensed Vocational Nurse | 512 S Kearny, Clarendon, TX 79226 | 2018-08-15 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1013437870 | Kelly Dennis Smith | Public Health or Welfare | 211 Oakmont Dr, New Orleans, LA 70128-3624 | 2017-06-22 |
| 1164955498 | Kelly Ghislaine Smith | Student in an Organized Health Care Education/Training Program | 171 Old Chester Rd, Essex Fells, NJ 07021-1624 | 2017-04-04 |
| 1588026975 | Kelly Therese Smith | Specialist/Technologist | 344 S Maple Ave #2a, Oak Park, IL 60302 | 2016-03-24 |
| 1790168326 | Kelly Smith | Counselor | 545 Sw 26th St, Oklahoma City, OK 73109-6740 | 2015-07-01 |
| 1518353341 | Kelly Smith | Nurse Practitioner | 2232 Wilborn Ave Ste D, South Boston, VA 24592-1662 | 2015-04-08 |
| 1265830491 | Kelly Sue Smith | Speech-Language Pathologist | 210 Starpine Pl Unit A, Prescott, AZ 86303-7017 | 2014-12-22 |
| Street Address |
47 JOLLEY DR |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-3092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366403107 | Lynn Fairchild | Physician Assistant | 47 Jolley Dr, Bloomfield, CT 06002-3092 | 2006-03-31 |
| 1619145430 | Peter Donshik Md | Eyewear Supplier (Equipment, not the service) | 47 Jolley Dr, Bloomfield, CT 06002-3092 | 2008-02-14 |
| 1194740399 | Peter Clifford Donshik | Ophthalmology | 47 Jolley Dr, Bloomfield, CT 06002-3092 | 2006-07-12 |
| 1982665725 | Jennifer W Pennoyer | Dermatology | 47 Jolley Dr, Bloomfield, CT 06002-3092 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1104467919 | Caroline Suzanne Carey Oesch | Counselor | 71 West Dudley St, Bloomfield, CT 06002 | 2019-10-02 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1508348947 | Rebecca Perry | Student in an Organized Health Care Education/Training Program | 693 Bloomfield Avenue, Bloomfield, CT 06002 | 2018-09-01 |
| 1760996946 | Monique Edwards | Social Worker | 705 New Briatin Ave, Chd, Bloomfield, CT 06002 | 2017-11-27 |
| 1225564412 | Merva E Dixon | Nurse Practitioner | 38 Hill Farm Rd, Bloomfield, CT 06002 | 2017-05-07 |
| 1538602610 | Jaime Acevedo | Counselor | 571 Bloomfield Ave, Bloomfield, CT 06002 | 2016-11-22 |
| 1669835138 | Jacob Badura | Pharmacist | 799-824 Park Ave, Bloomfield, CT 06002 | 2016-04-01 |
| 1316283328 | Julie Jason Farrelly | Counselor | 45 Wintonbury Ave Ste 102, Bloomfield, CT 06002 | 2012-12-19 |
| 1184915860 | Rachel Benedetto Scott | Surgery | 6 Northwestern Drive, Suite 305, Bloomfield, CT 06002 | 2011-04-28 |
| Find all providers in zip 06002 | ||||
| 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 |
|---|---|---|---|---|
| 1134738396 | Audrey Alicia Merenda | Physician Assistant | 1255 Broad St Ste 201b, Bloomfield, NJ 07003-3061 | 2020-07-23 |
| 1780236489 | Kaitlin M Bourdeau | Physician Assistant | 1255 Broad St Ste 201a, Bloomfield, NJ 07003-3061 | 2019-07-12 |
| 1548275092 | Kristin C Overton | Physician Assistant | 35 Jolley Dr Ste 301, Bloomfield, CT 06002-4228 | 2006-07-30 |
| 1366403107 | Lynn Fairchild | Physician Assistant | 47 Jolley Dr, Bloomfield, CT 06002-3092 | 2006-03-31 |
| 1275008153 | Brian W. Remes | Physician Assistant | 580 Cottage Grove Rd, Bloomfield, CT 06002-3088 | 2018-10-08 |
| 1093115057 | Daniela Shvetsov | Physician Assistant | 701 Cottage Grove Rd, Suite E210, Bloomfield, CT 06002-3080 | 2014-08-27 |
| 1346430709 | Lisa M Nakashian | Physician Assistant | 1 Barnard Ln, Suite 201, Bloomfield, CT 06002-2481 | 2007-07-31 |
| 1639261779 | Maria Annal | Physician Assistant | 580 Cottage Grove Rd, Suite 107, Bloomfield, CT 06002-3088 | 2006-09-28 |
| 1346261013 | Jessica B Ice | Physician Assistant | 107 Perry St, Bloomfield, KY 40008 | 2006-07-21 |
| 1598713885 | Kevin D. Lauck | Physician Assistant | 110 E Main St, Bloomfield, NE 68718-4408 | 2006-05-05 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 06002 |
Please comment or provide details below to improve the information on KELLY O SMITH.
| 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.