MR. STEPHEN M KELLY (NPI# 1861023343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861023343 |
| Entity Type | Individual |
| Full Name | MR. STEPHEN M KELLY |
| Practice Address |
N8021 Lake Breeze Dr Sherwood WI 54169-9613 |
| Practice Telephone | 9209897934 |
| Mailing Telephone | 9209897934 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235781584 | Stephen Kelly | Student in an Organized Health Care Education/Training Program | 2114 E Pinnacle Terrace Way Apt 302, Cottonwood Heights, UT 84121-5086 | 2019-07-16 |
| 1457601098 | Stephen Patrick Kelly | Mechanotherapist | 6080 Jericho Tpke Ste 200, Commack, NY 11725-2808 | 2012-09-11 |
| 1558504258 | Stephen Michael Kelly | Emergency Medicine | 333 Grand St, Ed - Jersey City Medical Center, Jersey City, NJ 07302-4319 | 2009-04-09 |
| 1245367663 | Stephen Michael Kelly | Internal Medicine | 1501 River Pointe Dr Ste 240, Conroe, TX 77304-2861 | 2007-02-27 |
| 1770652349 | Stephen Michael Kelly | Optometrist | 851 Cherry Ave, Bayhill Center #25, San Bruno, CA 94066-2900 | 2006-11-07 |
| 1699722504 | Stephen Kelly | Physical Therapist | 80 Mill St, 1, Newton, NJ 07860-1411 | 2006-05-27 |
| 1689678518 | Stephen Kelly | Chiropractor | 403 S 3rd St, Youngwood, PA 15697-1154 | 2005-06-09 |
| 1457876310 | Stephen Michael Kelly | Registered Nurse | 1500 E Medical Center Dr, 1h247 University Hospital, Ann Arbor, MI 48109-5048 | 2017-08-11 |
| 1023321304 | Stephen Michael Kelly | Nurse Anesthetist, Certified Registered | 2021 Perdido St, New Orleans, LA 70112-1352 | 2010-07-15 |
| 1205059169 | Stephen J Kelly | Ophthalmology | 1830 14th Ave S, Birmingham, AL 35205-4969 | 2007-04-10 |
| Street Address |
N8021 LAKE BREEZE DR |
| City | SHERWOOD |
| State | WI |
| Zip Code | 54169-9613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972838233 | Joseph Edward Pilon Jr. | Orthopaedic Surgery | W4933 Palisades Trail, Sherwood, WI 54169 | 2009-10-05 |
| 1356386155 | Family Focused Vision Care, LLC | Optometrist | W575 Castle Dr., Sherwood, WI 54169 | 2006-06-17 |
| 1487770467 | Sherwood Dental S.c. | Dentist | North 275 Military Rd., Sherwood, WI 54169 | 2007-03-22 |
| 1164546503 | Sidney B. Schulz | Dentist | North 275 Military Rd., Sherwood, WI 54169-0159 | 2007-03-19 |
| 1194079210 | Daul Anesthesia Inc | Nurse Anesthetist, Certified Registered | W4855 Mustang Dr, Sherwood, WI 54169-9505 | 2012-10-29 |
| 1053666768 | Peter Altfillisch | Pharmacist | W5077 Cherrywood Ct, Sherwood, WI 54169-9510 | 2012-07-18 |
| 1316975683 | Shannon Peterson | Chiropractor | N275 Military Rd, Suite 2, Sherwood, WI 54169-9603 | 2006-06-28 |
| 1730613555 | Megan Wolfinger | Dentist | N275 Military Rd, Sherwood, WI 54169-9603 | 2017-04-18 |
| 1396812905 | Sherwood Chiropractic Sc | Chiropractor | N275 Military Rd, Suite 2, Sherwood, WI 54169-9603 | 2006-11-29 |
| 1578606208 | Christine Mary Matthias | Occupational Therapy Assistant | N8015 Lake Breeze Dr, Sherwood, WI 54169-9613 | 2007-02-14 |
| Find all providers in zip 54169 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144850967 | Victoria Lynn Rollins | Specialist/Technologist | 8 Christopher Dr, Sherwood, AR 72120-4010 | 2020-01-21 |
| 1235616525 | Lance Craig Hunter | Specialist/Technologist | 133 Shadow Oaks Dr, Sherwood, AR 72120-6056 | 2018-07-19 |
| 1134528995 | Jordan Bigam | Specialist/Technologist | 20385 Sw Edy Rd, Sherwood, OR 97140-7407 | 2014-08-18 |
| 1922242544 | Travis Laloli | Specialist/Technologist | 16956 Sw Meinecke Rd, Sherwood, OR 97140-9061 | 2009-04-27 |
| 1124156328 | Jeffrey James Crapper | Specialist/Technologist | Sherwood High School, 16956 Sw Meinecke Rd., Sherwood, OR 97140 | 2007-03-01 |
| 1336761154 | Bryson North | Specialist/Technologist | 6289 Us Highway 127, Sherwood, OH 43556-9735 | 2020-05-14 |
| 1104470806 | Jacqueline Marie Komarek | Specialist/Technologist | 7507 Warden Rd, Sherwood, AR 72120-5042 | 2019-07-31 |
| 1275195935 | Carolyn 'caz' Mary Thomson | Specialist/Technologist | 23000 Sw Pacific Hwy, Sherwood, OR 97140-8061 | 2019-07-02 |
| 1225314610 | Courtney Heyl | Specialist/Technologist | 9880 Brockington Rd, Ste 147, Sherwood, AR 72120-3585 | 2011-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657329 | Tyler John Friis | Specialist/Technologist | 1514 E Keystone Ln, Appleton, WI 54913-7162 | 2020-10-21 |
| 1184222085 | Ryan James Mcnamara | Specialist/Technologist | 28914 Golden Cir, Waterford, WI 53185-1197 | 2020-10-13 |
| 1770198699 | Tanner Sterling | Specialist/Technologist | 2538 E Garrison Rd, Foxboro, WI 54836-9507 | 2020-09-09 |
| 1922626670 | Eric William Brostrom | Specialist/Technologist | 3305 Lilly Rd, Brookfield, WI 53005-7608 | 2020-07-09 |
| 1174146690 | Brycen Valiga | Specialist/Technologist | 4477 S 113th St, Greenfield, WI 53228-2566 | 2020-05-19 |
| 1104448307 | Xeing Randy Yang | Specialist/Technologist | 2207 Namekagon St, Hudson, WI 54016-9426 | 2020-05-11 |
| 1073134615 | Brian Wood | Specialist/Technologist | 1950 Washington St, Grafton, WI 53024-2103 | 2020-05-06 |
| 1124649751 | Cody Scott Tesch | Specialist/Technologist | 6680 N Teutonia Ave, Milwaukee, WI 53209-3117 | 2020-05-05 |
| 1659992642 | Kelley Potila | Specialist/Technologist | 255 Maggilu Ct, Jefferson, WI 53549-2095 | 2020-04-30 |
| 1366070708 | Claire Duwell | Specialist/Technologist | 9111 W Bluemound Rd, Milwaukee, WI 53226-4506 | 2020-03-31 |
| Find all providers with the same taxonomy | ||||
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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.