TYLER P KELLY (NPI# 1962818864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962818864 |
Entity Type | Individual |
Full Name | TYLER P KELLY |
Credential | NP |
Practice Address |
250 E Day Rd Suite 300 Mishawaka IN 46545-3471 |
Practice Telephone | 5749680283 |
Practice Fax Number | 5748555699 |
Mailing Telephone | 5749680283 |
Mailing Fax Number | 5748555699 |
Enumeration Date | 2014-07-11 |
Last Update Date | 2016-12-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71005109A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | APN PRESCRIPTIVE AUTHORITY | 71005109A | 01 |
IN | CSR PRESCRIPTIVE AUTHORITY | 71005109B | 01 |
IN | 201252820 | 05 | |
IN | RN LICENSE | 28189341A | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639401151 | Tyler Justin Kelly | Chiropractor | 815 Grandview Ave, Ste 250, Columbus, OH 43215-1254 | 2010-02-09 |
1336667419 | Tyler R Kelly | Physical Therapy Assistant | 1421 3rd St Sw, Roanoke, VA 24016-5204 | 2017-09-08 |
1689100935 | Tyler Kelly | Family Medicine | 101 Dates Dr, Ithaca, NY 14850-1342 | 2017-05-05 |
1023458478 | Tyler J. Kelly | Podiatrist | 225 Crosslake Dr, Evansville, IN 47715-8198 | 2013-06-30 |
Street Address |
250 E DAY RD SUITE 300 |
City | MISHAWAKA |
State | IN |
Zip Code | 46545-3471 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114125945 | Nephrology Inc. | Clinic/Center | 250 E Day Rd, Suit 300, Mishawaka, IN 46545-3471 | 2007-07-03 |
1386162709 | Carrie Yarger | Physical Therapist | 250 E Day Rd, Mishawaka, IN 46545-3471 | 2017-09-06 |
1780106559 | Lilian Kagendo Mwangi | Nurse Practitioner | 250 E Day Rd, Mishawaka, IN 46545-3471 | 2017-07-12 |
1003357377 | Nephrology Physicians LLC | Clinic/Center | 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471 | 2017-03-20 |
1932645900 | Kelly Stevens | Occupational Therapist | 250 E Day Rd, Mishawaka, IN 46545-3471 | 2017-01-13 |
1275079345 | Genevieve Luther | Physical Therapist | 250 E Day Rd, Mishawaka, IN 46545-3471 | 2017-01-13 |
1346790235 | North American Partners In Anesthesia Indiana LLC | Anesthesiology | 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471 | 2016-10-04 |
1144774738 | Saint Joseph Pace | Clinic/Center | 250 E Day Rd, Mishawaka, IN 46545-3471 | 2016-08-11 |
1326310160 | Mary-kate Oatman | Nurse Practitioner | 250 E Day Rd, Mishawaka, IN 46545 | 2012-02-08 |
1205163276 | Fms Nephrology Partners North Central Indiana Dialysis Centers, LLC | Clinic/Center | 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471 | 2009-11-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
Find all providers in zip 46545 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467092908 | Tori Driver | Nurse Practitioner | 3005 Grape Rd Ste B, Mishawaka, IN 46545-2709 | 2020-01-13 |
1093272593 | Regina Lynn Yoder | Nurse Practitioner | 303 S Main St Ste 111, Mishawaka, IN 46544-2159 | 2019-02-21 |
1376021725 | Kaley Michelle Marino | Nurse Practitioner | 1113 Mossy Ln, Mishawaka, IN 46544-9055 | 2018-07-29 |
1386192870 | Melinda C Nwanganga | Nurse Practitioner | 4501 Lincolnway E, Mishawaka, IN 46544-4035 | 2016-09-14 |
1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
1578692794 | Lynn Davis Figg | Nurse Practitioner | 611 East Douglas Road, Suite 405, Mishawaka, IN 46545-1468 | 2007-03-05 |
1376557702 | Patricia L Jackson | Nurse Practitioner | 230 W Catalpa Dr, Suite D, Mishawaka, IN 46545-8321 | 2006-07-28 |
1467406074 | Saint Joseph Regional Medical Center, Inc. | Nurse Practitioner | 60101 Bodnar Blvd Ste 100b, Mishawaka, IN 46544-9340 | 2006-05-19 |
1518955327 | Tori Dawn Clabaugh | Nurse Practitioner | 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 | 2005-10-06 |
Find all providers in MISHAWAKA |
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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.