KELLI M BURRESS (NPI# 1912203894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912203894 |
| Entity Type | Individual |
| Full Name | KELLI M BURRESS |
| Other Name | KELLI M WILSON |
| Credential | NP |
| Practice Address |
309 Medic Way Greencastle IN 46135-2296 |
| Mailing Address |
8840 Commerce Park Pl Ste E Indianapolis IN 46268-3129 |
| Practice Telephone | 7656532626 |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2016-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71003520 | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71003520A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201019020 | 05 |
| Street Address |
309 MEDIC WAY |
| City | GREENCASTLE |
| State | IN |
| Zip Code | 46135-2296 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336122647 | Brian Edward Downen | Family Medicine | 309 Medic Way, Greencastle, IN 46135-2296 | 2005-11-22 |
| 1437750015 | Putnam County Hospital | Clinic/Center | 309 Medic Way, Greencastle, IN 46135-2296 | 2020-11-02 |
| 1144717000 | Benjamin Scott | Nurse Practitioner | 309 Medic Way, Greencastle, IN 46135-2296 | 2018-04-17 |
| 1407122666 | Adam David Amos | Family Medicine | 309 Medic Way, Greencastle, IN 46135-2296 | 2012-03-31 |
| 1366721060 | Brandie Denise Ruark | Nurse Practitioner | 309 Medic Way, Greencastle, IN 46135-2296 | 2011-08-11 |
| 1811977630 | Lisa Marie Bozarth | Nurse Practitioner | 309 Medic Way, Greencastle, IN 46135-2296 | 2006-01-18 |
| 1295718310 | Warren L Macy | Family Medicine | 309 Medic Way, Greencastle, IN 46135 | 2005-11-22 |
| 1750364923 | Fred Emmett Haggerty | Family Medicine | 309 Medic Way, Greencastle, IN 46135-2296 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659916260 | Virginia Kay St. John | Technician | 961 Deer Field Court, Greencastle, IN 46135 | 2019-11-07 |
| 1205478138 | Hannah Aker Evans | Nurse Practitioner | Putnam County Hospital, 1542 S. Bloomington St., Greencastle, IN 46135 | 2019-10-11 |
| 1447627757 | Dental Professionals of In, P.C. | Dentist | 1012 Mill Pond Drive Suite A, Greencastle, IN 46135 | 2015-08-24 |
| 1982027702 | Putnam County Auditor | Public Health or Welfare | 1542 S. Bloomington Street, Suite 1500, Greencastle, IN 46135 | 2014-01-30 |
| 1679871685 | Lori A Bradbury | Speech-Language Pathologist | 1014 Mill Pond Lane, Greencastle, IN 46135 | 2011-03-01 |
| 1346568102 | Susan Maybaum | Occupational Therapist | 98 N 10th Street, Greencastle, IN 46135 | 2010-05-04 |
| 1710065065 | Putnam County Comprehensive Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 914 Tennessee St, Greencastle, IN 46135 | 2006-11-02 |
| 1619053626 | Putnam County Comprehensive Service | Day Training, Developmentally Disabled Services | 630 Tennessee St, Greencastle, IN 46135 | 2006-10-31 |
| 1851474167 | Thomas Houston Black IIi | Family Medicine | 1145 Indianapolis Road, Greencastle, IN 46135 | 2006-10-23 |
| 1861574782 | Wal-mart Stores East, Lp | Technician/Technologist | 1750 E. Indianapolis, Greencastle, IN 46135 | 2006-10-19 |
| Find all providers in zip 46135 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205478138 | Hannah Aker Evans | Nurse Practitioner | Putnam County Hospital, 1542 S. Bloomington St., Greencastle, IN 46135 | 2019-10-11 |
| 1467915330 | Chelsea Ann Stephenson | Nurse Practitioner | 1542 S Bloomington St, Greencastle, IN 46135-2297 | 2019-04-09 |
| 1588120919 | Leanna Hollingshead | Nurse Practitioner | 24 Antrim Commons Dr, Greencastle, PA 17225-1623 | 2019-02-11 |
| 1144717000 | Benjamin Scott | Nurse Practitioner | 309 Medic Way, Greencastle, IN 46135-2296 | 2018-04-17 |
| 1871005819 | Candace Vera Deverell | Nurse Practitioner | 50 Eastern Ave Ste 135, Greencastle, PA 17225-1195 | 2017-10-31 |
| 1801278643 | Nina Friant Geiger | Nurse Practitioner | 24 Antrim Commons Dr, Greencastle, PA 17225 | 2015-06-28 |
| 1043698244 | Michelle Rae Modlin | Nurse Practitioner | 1542 S Bloomington St, Greencastle, IN 46135-2212 | 2015-05-08 |
| 1922497445 | Amy Lynn Warner | Nurse Practitioner | 50 Eastern Ave, Suite 144, Greencastle, PA 17225-1100 | 2015-01-21 |
| 1770971251 | Mindy Barnhart | Nurse Practitioner | 50 Eastern Ave Ste 135, Greencastle, PA 17225-1195 | 2015-01-06 |
| 1952717191 | Andrea S Baysinger | Nurse Practitioner | 1542 S Bloomington St, Greencastle, IN 46135-2212 | 2014-07-09 |
| Find all providers in GREENCASTLE | ||||
| City | GREENCASTLE |
| Zip Code | 46135 |
Please comment or provide details below to improve the information on KELLI M BURRESS.
| 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.