MATTHEW KELLY (NPI# 1881012532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881012532 |
| Entity Type | Individual |
| Full Name | MATTHEW KELLY |
| Practice Address |
3225 10th St E Glencoe MN 55336-3369 |
| Practice Telephone | 3208645026 |
| Mailing Telephone | 3208645026 |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2014-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 120522 | MN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033465042 | Matthew Kelly | Dentist | 9 E Van Buren St, Millstadt, IL 62260-2009 | 2012-07-27 |
| 1194864298 | Matthew Thomas Kelly | Chiropractor | 4035 Dixie Hwy, Elsmere, KY 41018-1813 | 2007-02-05 |
| 1891860904 | Matthew J Kelly | Family Medicine | 1114 Hickox St, Santa Fe, NM 87505-1088 | 2006-11-22 |
| 1942847918 | Matthew Spencer Kelly | Optometrist | 317 Clarkson Rd, Ellisville, MO 63011-2271 | 2019-12-09 |
| 1760031256 | Matthew Kelly | Physical Therapist | 463 Tremont St W Ste 100, Port Orchard, WA 98366-3743 | 2019-09-06 |
| 1013400886 | Matthew John Kelly | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2018-06-07 |
| 1891225801 | Matthew Kelly | Hearing Instrument Specialist | 1754 Madison St Ste A, Clarksville, TN 37043-2923 | 2017-06-13 |
| 1003363458 | Matthew P Kelly | Counselor | 14 Jackson St, Northampton, MA 01060-1606 | 2016-09-01 |
| 1013364082 | Matthew Kelly | Internal Medicine | 601 John St # 74, Kalamazoo, MI 49007 | 2016-05-19 |
| 1720432701 | Matthew Ryer Kelly | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2016-04-15 |
| Street Address |
3225 10TH ST E |
| City | GLENCOE |
| State | MN |
| Zip Code | 55336-3369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073567558 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 3225 10th St E, Glencoe, MN 55336-3369 | 2006-05-20 |
| 1356684245 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 3225 10th St E, Glencoe, MN 55336-3369 | 2013-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316429160 | Lisa M Thompson | Speech-Language Pathologist | 2105 Hennepin Avenue North, Glencoe, MN 55336 | 2018-08-29 |
| 1609207943 | Sherry Sue Henkelmann | Respite Care | 7768-160th St., Glencoe, MN 55336 | 2013-12-12 |
| 1528277449 | Kelly Jo Higgins | Pharmacist | 2211 11th St. E., Glencoe, MN 55336 | 2007-05-21 |
| 1124180450 | Randy Robert Johnson | Chiropractor | 1706 East Tenth Street, Gauer Chiropractic Clinic, Glencoe, MN 55336 | 2006-12-14 |
| 1790863751 | Merrill D Nelson | Dentist | 1015 Greeley Ave, Glencoe, MN 55336 | 2006-11-01 |
| 1902982481 | Michelle Marie Quale | Registered Nurse | 1805 Hennepin Ave. North, Glencoe Regional Health Services, Glencoe, MN 55336 | 2006-10-27 |
| 1417912122 | Lee Medical Inc | Durable Medical Equipment & Medical Supplies | 1209 Greeley Avenue, Glencoe, MN 55336 | 2006-04-18 |
| 1154319705 | Kristine Leonard Knudten | Family Medicine | 1805 Hennepin Ave North, Glencoe, MN 55336 | 2005-10-07 |
| 1285120477 | Nicole Nash | Registered Nurse | 1805 Hennepin Ave N, Glencoe, MN 55336 | 2018-07-10 |
| 1841640091 | Rachael Stoebe | Hearing Instrument Specialist | 2915 10th St E, Glencoe, MN 55336 | 2016-06-20 |
| Find all providers in zip 55336 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194006767 | Jerry Suttin | Pharmacist | 63 Green Bay Rd, Glencoe, IL 60022-4416 | 2011-09-08 |
| 1528277449 | Kelly Jo Higgins | Pharmacist | 2211 11th St. E., Glencoe, MN 55336 | 2007-05-21 |
| 1720103088 | Robert Alan Neal | Pharmacist | 544 Main St W, Glencoe, AL 35905-1060 | 2007-03-19 |
| 1962784041 | Denise L Nalaboff | Pharmacist | 63 Green Bay Rd, Glencoe, IL 60022-4416 | 2011-09-14 |
| 1437430527 | Jeri Summers | Pharmacist | 353 Park Ave, Glencoe, IL 60022-1530 | 2011-09-01 |
| 1306127402 | Edwin Levin | Pharmacist | 353 Park Ave, Glencoe, IL 60022-1530 | 2011-09-01 |
| 1720369200 | Nancy J Davis | Pharmacist | 353 Park Ave, Glencoe, IL 60022-1530 | 2011-08-29 |
| 1225248040 | Ronald Roy Smith | Pharmacist | 544 Main St W, Glencoe, AL 35905-1060 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1295334217 | Mary Jane Andersen | Pharmacist | 3300 Hwy 210 W, Fergus Falls, MN 56537 | 2020-10-21 |
| 1679172522 | Cari Michelle Labonne | Pharmacist | 4202 Creekwood Pl, Hermantown, MN 55811-3692 | 2020-10-21 |
| 1073112983 | Katie Sue Fairchild | Pharmacist | 2301 E Frontage Rd, Litchfield, MN 55355 | 2020-10-21 |
| 1609475615 | Blaine Perry Ecker | Pharmacist | 3300 Highway 210 W., 3300 Highway 210 West, Fergus Falls, MN 56537 | 2020-10-21 |
| 1619576626 | Jessica Margaret Dulli | Pharmacist | 5241 Lincoln Dr Apt 204, Edina, MN 55436-2702 | 2020-10-21 |
| 1649879875 | Dale Rudolph | Pharmacist | 320 22nd Ave Ne, Waseca, MN 56093-2670 | 2020-10-19 |
| 1134728520 | Herve Bertrand Kengne Mbakam | Pharmacist | 1800 Windsor Dr S, Shakopee, MN 55379-8073 | 2020-10-18 |
| 1821696402 | Leah Fischer | Pharmacist | 817 11th St N, New Ulm, MN 56073-1374 | 2020-10-15 |
| 1003414780 | Loren Leroy Carver | Pharmacist | 424 3rd St N, Stillwater, MN 55082-4836 | 2020-10-14 |
| 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.