MRS. COLLEEN DENISE KELLEY (NPI# 1861433088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861433088 |
| Entity Type | Individual |
| Full Name | MRS. COLLEEN DENISE KELLEY |
| Credential | PA-C |
| Practice Address |
11234 Leatherwood Dr Reston VA 20191-4607 |
| Mailing Address |
12255 Fair Lakes Pkwy Fairfax VA 22033-3952 |
| Practice Telephone | 7033910758 |
| Practice Fax Number | 7033910758 |
| Mailing Telephone | 7039345700 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2010-11-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110840732 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346659604 | Colleen Kelley | Occupational Therapist | 218 Redondo Ave Apt 7, Long Beach, CA 90803-5903 | 2014-08-11 |
| 1437108396 | Colleen T Kelley | Specialist | 120 Silver Lake Rd, Middletown, DE 19709-1225 | 2006-05-09 |
| 1932737301 | Colleen Kelley | Physical Therapy Assistant | 31 Vauxhall St, New London, CT 06320-5723 | 2020-03-31 |
| 1215575709 | Colleen Kelley | Occupational Therapy Assistant | 130 Lomond Ct, Utica, NY 13502-5957 | 2019-12-15 |
| 1073947941 | Colleen Marie Kelley | Counselor | 401 Cypress St, Manchester, NH 03103-3628 | 2013-08-28 |
| 1922282490 | Colleen F Kelley | Internal Medicine | 69 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3033 | 2007-12-20 |
| 1164518940 | Colleen Ruth Kelley | Counselor | 564 Ne Ravenna Blvd, Seattle, WA 98115 | 2006-10-05 |
| 1427032119 | Colleen Elizabeth Kelley | Emergency Medicine | 1300 Massachusetts Ave, Emergency Dept St Marys Hospital, Troy, NY 12180-1628 | 2005-12-06 |
| Street Address |
11234 LEATHERWOOD DR |
| City | RESTON |
| State | VA |
| Zip Code | 20191-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275150518 | Grace Andales Soistman | Nurse Practitioner | 11160 South Lakes Dr. Reston, Va 20191, Reston, VA 20191 | 2020-07-02 |
| 1790317709 | Twenty Four/7 LLC | Private Vehicle | 11922 Winterthur Ln, 103, Reston, VA 20191 | 2020-02-07 |
| 1437626058 | Aramesh Darvishian Dds Pllc | Dentist | 12040 South Lakes Dr. Suite 200, Reston, VA 20191 | 2018-11-01 |
| 1992282693 | Ashkan Ghods | Home Health | 11760 Sunrise Valley Dr, #405, Reston, VA 20191 | 2018-07-25 |
| 1104319698 | Capital Critical Care & Informatics PC | Internal Medicine | 11890 Sunrise Valley Dr # 442, Reston, VA 20191 | 2018-06-11 |
| 1063930683 | Mackenzie Marie Evans | Specialist/Technologist | 2380 Branleigh Park Ct, Reston, VA 20191 | 2017-09-04 |
| 1073910345 | Jane L Mahan-wiegand | Dietitian, Registered | 1900 Campus Commons Drive, Suite 100, Reston, VA 20191 | 2014-12-02 |
| 1700214293 | Sonny Sunghun Kim | Dentist | 11876 Sunrise Valley Drive, 101, Reston, VA 20191 | 2013-10-22 |
| 1982036786 | Stephanie Lourdes Miller | Physician Assistant | 12040 South Lakes Drive, Suite 207, Generations Family Practice, Reston, VA 20191 | 2013-08-02 |
| 1316250988 | Thao Ngoc Vuong | Pharmacist | 1898 Winterport Cluster, Reston, VA 20191 | 2010-07-23 |
| Find all providers in zip 20191 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427487784 | Samantha Major Frazier | Physician Assistant | 1860 Town Center Dr Ste 240, Reston, VA 20190-5899 | 2013-11-07 |
| 1053413385 | Elizabeth Hamilton Sibert | Physician Assistant | 11130 Sunrise Valley Dr, #150, Reston, VA 20191-4398 | 2006-09-05 |
| 1598322406 | Agata Alicja Greer | Physician Assistant | 1860 Town Center Dr Ste 240, Reston, VA 20190-5899 | 2019-05-26 |
| 1528624772 | Madison Staub | Physician Assistant | 1939 Roland Clarke Pl Ste 200, Reston, VA 20191-1445 | 2019-05-14 |
| 1215415724 | Erin Leishman | Physician Assistant | 11800 Sunrise Valley Dr Ste 800, Reston, VA 20191-5320 | 2018-08-06 |
| 1104169507 | Ashley Rose Gilchrist | Physician Assistant | 1831 Wiehle Ave, Reston, VA 20190-5266 | 2013-04-03 |
| 1356697601 | Heather S Groves | Physician Assistant | 1850 Town Center Pkwy, Reston, VA 20190-3219 | 2012-07-24 |
| 1235413667 | Larry C Mack-wilson | Physician Assistant | 1850 Town Center Pkwy, Reston, VA 20190-3219 | 2011-10-04 |
| 1952553935 | Wendy Nichole Cohen | Physician Assistant | 12359 Sunrise Valley Dr, Suite 320, Reston, VA 20191-3462 | 2008-10-21 |
| 1891960407 | Barbara L Parkinson | Physician Assistant | 11800 Sunrise Valley Dr, Reston, VA 20191 | 2008-04-24 |
| Find all providers in RESTON | ||||
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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.