EDWARD ROBERT KELLY (NPI# 1891344024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891344024 |
| Entity Type | Individual |
| Full Name | EDWARD ROBERT KELLY |
| Practice Address |
512 N Campus Ithaca NY 14853-6007 |
| Mailing Address |
214 E Upland Rd Ithaca NY 14850-2255 |
| Practice Telephone | 6072554237 |
| Mailing Telephone | 6072554237 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
000039 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NEW YORK SATE | 00039 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417289927 | Edward Allen Kelly | General Practice | 315 Hillsboro St, Pittsboro, NC 27312-9313 | 2010-02-08 |
| 1164616488 | Edward M Kelly Jr. | Dentist | 1726 W Jarrettsville Rd, Jarrettsville, MD 21804-1524 | 2007-08-29 |
| 1235122300 | Edward A. Kelly Jr. | Family Medicine | 99 Manor Ave, Downingtown, PA 19335-2620 | 2005-08-24 |
| 1679134910 | Edward Joseph Kelly Iv | Surgery | Musc Gme Office 169 Ashley Avenue Room 202 Muh Msc 33, Charleston, SC 29425-0001 | 2019-06-26 |
| 1326450073 | Edward M Kelly | Physical Therapy Assistant | 11039 Dugway Rd, Fillmore, NY 14735-8610 | 2014-05-29 |
| 1699015610 | Edward George Kelly | Orthopaedic Surgery | 212 9th St, Pittsburgh, PA 15222-3517 | 2013-02-28 |
| 1124315957 | Edward T Kelly Iv | Dentist | 114 Woodland St, Hartford, CT 06105-1208 | 2011-06-30 |
| 1083890503 | Edward Lawrence Kelly Jr. | Licensed Practical Nurse | 711 S Vine St, Glenwood, IA 51534-1927 | 2008-01-15 |
| 1609929074 | Edward James Kelly | Chiropractor | 231 W Patison St, Port Hadlock, WA 98339-9751 | 2007-01-19 |
| 1235146689 | Edward Kelly | Dentist | 5900 Spout Springs Rd, Ste U-21, Flowery Branch, GA 30542-6448 | 2006-08-01 |
| Street Address |
512 N CAMPUS |
| City | ITHACA |
| State | NY |
| Zip Code | 14853-6007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334928 | Jocelyn Joy Stark | Specialist/Technologist | 512 N Campus, Ithaca, NY 14853-6007 | 2019-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174018071 | Bernard Francis Depalma | Physical Therapist | Cornell University, 512 Campus Road, Teagle Hall, Ithaca, NY 14853 | 2018-06-25 |
| 1538665369 | Audrey Hulbert | Registered Nurse | Cornell Health, 110 Ho Plaza, Ithaca, NY 14853 | 2018-04-02 |
| 1851714752 | College of Veterinary Medicine | Pharmacy | Cornell University Phcy-vmc Bldg, Tower Rd, Ithaca, NY 14853 | 2014-01-28 |
| 1033486899 | Philipp Ewert | Specialist/Technologist | 512 Campus Road, Tegal Hall, Ithaca, NY 14853 | 2011-11-22 |
| 1174828339 | Jennifer A Keough | Specialist/Technologist | Teagle Hall, Campus Rd, Cornell University, Ithaca, NY 14853 | 2011-01-20 |
| 1811029275 | Chris Scarlata | Specialist/Technologist | Teagle Hall, Campus Rd., Ithaca, NY 14853 | 2007-03-12 |
| 1720077563 | Katherine Heiss Zang | Family Medicine | 110 Ho Plaza, Gannett Health Services, Ithaca, NY 14853 | 2005-10-14 |
| 1407496250 | Momina Hayy Mastan | Registered Nurse | 110 Ho Plz, Cornell Health, Ithaca, NY 14853 | 2020-01-09 |
| 1982267845 | Rachel Coye | Registered Nurse | 110 Ho Plz, Cornell Health, Ithaca, NY 14853 | 2019-04-17 |
| 1871055160 | Mark Slattery | Registered Nurse | 110 Ho Plz, Cornell Health, Ithaca, NY 14853 | 2019-04-04 |
| Find all providers in zip 14853 | ||||
| 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 |
|---|---|---|---|---|
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1790334928 | Jocelyn Joy Stark | Specialist/Technologist | 512 N Campus, Ithaca, NY 14853-6007 | 2019-09-10 |
| 1124677356 | Casey Williamson | Specialist/Technologist | 521 N Campus, Ithaca, NY 14853-6007 | 2019-09-10 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1780198101 | Katelyn Ellen Dolan | Specialist/Technologist | 1033 Danby Rd, Ithaca, NY 14850-7007 | 2017-11-21 |
| 1629310685 | Adam J Long | Specialist/Technologist | 310 Taughannock Blvd Ste 5a, Ithaca, NY 14850-3251 | 2013-03-18 |
| 1033486899 | Philipp Ewert | Specialist/Technologist | 512 Campus Road, Tegal Hall, Ithaca, NY 14853 | 2011-11-22 |
| 1104193077 | Cody Mason Herbert | Specialist/Technologist | 512 Campus Rd., Teagle Hall, Ithaca, NY 14850 | 2011-11-21 |
| 1174828339 | Jennifer A Keough | Specialist/Technologist | Teagle Hall, Campus Rd, Cornell University, Ithaca, NY 14853 | 2011-01-20 |
| 1760705883 | Daniel Edward King | Specialist/Technologist | 891a Taughannock Blvd, Ithaca, NY 14850-9501 | 2010-03-03 |
| Find all providers in ITHACA | ||||
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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.