MS. MARY ELLEN KELLY (NPI# 1962440842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962440842 |
| Entity Type | Individual |
| Full Name | MS. MARY ELLEN KELLY |
| Credential | NP |
| Practice Address |
2650 Ne Courtney Dr Bend OR 97701-7636 |
| Practice Telephone | 5416475200 |
| Mailing Telephone | 5416475200 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2015-12-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
200541672RN | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558844811 | Mary Elizabeth Kelly | Social Worker | 97 Libbey Industrial Pkwy Ste 301, Weymouth, MA 02189-3110 | 2018-09-12 |
| 1215410790 | Mary Jane Kelly | Dietitian, Registered | 1046 E Elgenia Ave, West Covina, CA 91790-1318 | 2018-09-11 |
| 1073020590 | Mary Teresa Kelly | Counselor | 726 Cherryvale Rd, Boulder, CO 80303-2911 | 2018-01-05 |
| 1972040459 | Mary A Kelly | Registered Nurse | 116 N Lake Ave, Albany, NY 12206-2710 | 2017-01-23 |
| 1073904215 | Mary Kelly | Registered Nurse | 3145 State Route 718, Troy, OH 45373-8908 | 2015-02-10 |
| 1174924054 | Mary Kelly | Nurse Practitioner | 14435 15th Ave, Whitestone, NY 11357-2407 | 2014-09-10 |
| 1306058714 | Mary Catherine Kelly | Nurse Practitioner | 275 Riverside Ave, Riverside, CT 06878-2313 | 2007-05-06 |
| 1134340086 | Mary Kris Kelly | Nurse Practitioner | 1 Gustave L Levy Pl # 1030, New York, NY 10029-6500 | 2007-05-01 |
| 1518187772 | Mary Ann Kelly | Dietary Manager | 6448 Hallee Rd Ste 9, Joshua Tree, CA 92252-1908 | 2007-04-27 |
| 1003036583 | Mary Anne Kelly | Marriage & Family Therapist | 105 Sunnyside Ave, Piedmont, CA 94611-4419 | 2007-04-26 |
| Street Address |
2650 NE COURTNEY DR |
| City | BEND |
| State | OR |
| Zip Code | 97701-7636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184675803 | Portland Vamc | Clinic/Center | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2006-05-15 |
| 1679172845 | Sharmy Rasheed | Social Worker | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2020-10-20 |
| 1861844029 | Christen Elaine Bales | Social Worker | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2016-07-12 |
| 1346493087 | James T Lee | Pharmacist | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2008-10-28 |
| 1275792053 | Misoo Kim Abele | Psychiatry & Neurology | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2008-06-05 |
| 1093931925 | Clear Choice Health Plans, Inc. | Point of Service | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2007-04-18 |
| 1134250566 | Joseph W Flannery | Internal Medicine | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2007-03-08 |
| 1417977042 | Danette Rai Elliott-mullens | Internal Medicine | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467600767 | John Martin Battle | Nurse Practitioner | 1612 Nw Overlook Dr, Bend, OR 97701 | 2008-08-29 |
| 1326263500 | Molly Laura Bourgault | Nurse Practitioner | 19537 Sager Loop, Bend, OR 97702 | 2007-04-14 |
| 1023383759 | Eden Renee Aldrich | Nurse Practitioner | 63333 Highway 20, Bend, OR 97703 | 2012-03-13 |
| 1205130309 | Carrie L Mcguigan | Nurse Practitioner | 1340 Nw Wall St, Bend, OR 97703-1985 | 2011-01-04 |
| 1396798377 | Anne Klein Kilty | Nurse Practitioner | 2577 Ne Courtney Dr, Bend, OR 97701-7638 | 2006-05-18 |
| 1720082795 | Deborah A Rogers | Nurse Practitioner | 2200 Ne Neff Rd, Ste 200, Bend, OR 97701-4281 | 2005-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992315972 | Deborah Marie Jones | Nurse Practitioner | 15800 Boones Ferry Rd Ste A6, Lake Oswego, OR 97035-3426 | 2020-08-05 |
| 1184257115 | Joanna Rae Farrell | Nurse Practitioner | 1650 Ne 32nd Ave Apt 425, Portland, OR 97232-3455 | 2020-02-18 |
| 1790241065 | Autumn D Mercer Agnp-c LLC | Nurse Practitioner | 1075 Shayla Ln, Central Point, OR 97502-2995 | 2019-02-12 |
| 1023590841 | Healthy At Home LLC | Nurse Practitioner | 3910 Ne 99th Ave, Portland, OR 97220-3620 | 2018-08-29 |
| 1437648946 | Stephanie Michele Johnson | Nurse Practitioner | 3560 Se 79th Ave, Portland, OR 97206-2372 | 2018-05-09 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| 1003275843 | Catherine Chiaradonna | Nurse Practitioner | 1867 Williams Hwy Ste 226, Grants Pass, OR 97527-5856 | 2016-02-22 |
| 1801266119 | Daniel Dominic Eric Roa | Nurse Practitioner | 5316 N Greeley Ave, Portland, OR 97217-4113 | 2015-09-29 |
| 1538578067 | Karen Lee Warren | Nurse Practitioner | 727 S Wahanna Rd Ste 100, Seaside, OR 97138-7735 | 2014-08-08 |
| 1245579408 | Derek Brent Kordenbrock | Nurse Practitioner | 625 Sw Ramsey Ave Ste A, Grants Pass, OR 97527-5808 | 2013-02-07 |
| 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.