COLIN KENNETH KELLY (NPI# 1972953339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972953339 |
| Entity Type | Individual |
| Full Name | COLIN KENNETH KELLY |
| Credential | M.D. |
| Practice Address |
Bureau of Medicine & Surgery Detachment Nas Jacksonville, Building 554 Jacksonville FL 32212 |
| Practice Telephone | 8437946994 |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2018-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 0101264704 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8901 Wisconsin Ave, General Surgery, Wrnmmc, Bethesda, MD 208890004 | 3013194462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265844930 | Colin Michael Kelly | Specialist/Technologist | 140b Peach Ln, West Leechburg, PA 15656-1506 | 2014-05-28 |
| 1093862088 | Colin K Kelly | Pediatrics | 4132 E Morrison Ranch Pkwy, Gilbert, AZ 85296-3093 | 2007-01-04 |
| 1215488879 | Colin Kelly | Registered Nurse | 402 S 4th Ave, Yakima, WA 98902-3546 | 2016-10-19 |
| Street Address |
BUREAU OF MEDICINE & SURGERY DETACHMENT NAS JACKSONVILLE, BUILDING 554 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| 1083093991 | John Wunn Cancian Sr. | Orthopaedic Surgery | Bumed, Centralized Credential and Privileging Directora, 554 Keily Street, Jacksonville, FL 32212 | 2015-05-26 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680220 | Florida Injury & Regenerative Medicine, Pllc | General Practice | 8640 Philips Hwy Ste 10, Jacksonville, FL 32256-1208 | 2020-05-15 |
| 1689296808 | Sajid Khan Md LLC | General Practice | 4600 Touchton Rd E Ste 1150, Jacksonville, FL 32246-1542 | 2020-05-11 |
| 1396392767 | Yurelsy Galvez Ricardo | General Practice | 725 Middle Branch Way, Jacksonville, FL 32259-6201 | 2019-08-21 |
| 1639721772 | Deborah Brabham | General Practice | 10990 Lydia Estates Dr E, Jacksonville, FL 32218-6940 | 2019-07-09 |
| 1851868459 | Nursing On Demand Inc | General Practice | 1260 Mcduff Ave S # 3, Jacksonville, FL 32205-8030 | 2018-11-01 |
| 1295202984 | Summit Integrative Health, LLC | General Practice | 12627 San Jose Blvd Ste 305, Jacksonville, FL 32223-8639 | 2018-10-31 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1255859641 | Mcgowan Medical Centers, Pa | General Practice | 3021 N Main St, Jacksonville, FL 32206-2122 | 2017-09-06 |
| 1700247863 | Emily Calhoun | General Practice | 554 Kelly Ln, Jacksonville, FL 32234-3049 | 2016-03-16 |
| 1023402054 | Matthew Joesph Lash | General Practice | Naval Medical Center, 100 Brewster Blvd., Camp Lejeune, Jacksonville, NC 28547-2538 | 2015-03-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
Please comment or provide details below to improve the information on COLIN KENNETH KELLY.
| 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.