Tavoria Kellam, MW

Primary specialty

MidwifeTaxonomy code 176B00000X

License

F000971-1 Issued in NY

Practice address

1176 5TH Ave
2253 Third Avenue 3Rd FL
New York, NY 10029-6503

Phone

(212) 289-6650

Fax

(212) 360-5088

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Harlem Council for Human Services

  • Health Service Clinic/Center
  • New York, NY
  • NPI 1326253048
  NPD (past)
• East Harlem Council for Human Services Inc

  • Community/Retail Pharmacy
  • New York, NY
  • NPI 1124530084
  NPD (past)
• Mount Sinai Diagnostic and Treatment Center

  • Clinic/Center
  • New York, NY
  • NPI 1669476156
  NPD (past)
• Mount Sinai School of Medicine of New York University

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1972513646
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1376644096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 5TH AVE",
            "address_2": "#29A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293123",
            "telephone_number": "212-876-9448",
            "fax_number": "212-689-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE",
            "address_2": "2253 THIRD AVENUE 3RD FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-289-6650",
            "fax_number": "212-360-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "TAVORIA",
        "name_prefix": "Ms.",
        "credential": "MW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F000971-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02692359",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Kelaher, LCSW
• Eric R Kelhoffer, MD
• Shira Kelin, PSYD
• Janhawi Kelkar
• Charles B. Kellam, LCSW-R
• Lucia Kellar, PH.D.
• Andrew Kelleher, MD
• Catherine Kelleher
• Christine Kelleher
• Deirdre Clare Kelleher, M.D.

• Midwife in New York, NY
• Providers in New York, NY by specialty
• Midwife in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.