KENNETH GLEN WYS (NPI# 1003929712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003929712 |
| Entity Type | Individual |
| Full Name | KENNETH GLEN WYS |
| Credential | MD |
| Practice Address |
47111 Monroe St Indio CA 92201-6739 |
| Practice Telephone | 7603476191 |
| Practice Fax Number | 7607758017 |
| Mailing Telephone | 7603476191 |
| Mailing Fax Number | 7607758017 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | A64344 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
A64344 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 221 S Painted Mountain Dr, Las Vegas, NV 891482722 | 3238423442 |
| Street Address |
47111 MONROE ST |
| City | INDIO |
| State | CA |
| Zip Code | 92201-6739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699716282 | Charles Kent Anderson | Anesthesiology | 47111 Monroe St, Indio, CA 92201-6739 | 2006-06-08 |
| 1487291571 | Christophe La | Pharmacist | 47111 Monroe St, Indio, CA 92201-6739 | 2019-12-08 |
| 1053962050 | Drew Zimmer | Emergency Medicine | 47111 Monroe St, Indio, CA 92201-6739 | 2019-09-23 |
| 1235791674 | John-john Loreto | Nurse Practitioner | 47111 Monroe St, Indio, CA 92201-6739 | 2019-07-06 |
| 1902465453 | Aulora Elizabeth Hammers | Nurse Practitioner | 47111 Monroe St, Indio, CA 92201-6739 | 2019-06-09 |
| 1538727607 | Jana Spedaliere | Nurse Practitioner | 47111 Monroe St, Indio, CA 92201-6799 | 2019-06-03 |
| 1043774144 | Stefan Meers Estrada | Physician Assistant | 47111 Monroe St, Indio, CA 92201-6739 | 2019-01-23 |
| 1508378126 | Tad Woraratanadharm | Pharmacist | 47111 Monroe St, Indio, CA 92201-6739 | 2017-11-05 |
| 1487177663 | Carmen Edna Cheung | Pharmacist | 47111 Monroe St, Indio, CA 92201-6739 | 2017-07-19 |
| 1114373537 | Laleh Ghaffarian | Emergency Medicine | 47111 Monroe St, Indio, CA 92201-6739 | 2016-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151534 | Kayla Marie Berry | Licensed Vocational Nurse | Telecare Riverside County Psychiatric Health Facility, Indio, CA 92201 | 2020-03-31 |
| 1699327353 | Nawar Hadid | Dentist | 81735 Ca-111, Indio, CA 92201 | 2019-07-12 |
| 1427521889 | Thanh Trang Thi Nguyen Md Inc | Internal Medicine | 44100 Jefferson St., #e507, Indio, CA 92201 | 2019-01-09 |
| 1306328315 | Grant Nishimura | Dentist | 81-637, Suite 1, Ca-111, Indio, CA 92201 | 2018-09-06 |
| 1700363645 | Desert Physical Medicine | General Practice | 81765 Highway 111, Ste #3, Indio, CA 92201 | 2018-07-24 |
| 1336668151 | U & I Care Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 44105 Jackson St Ste 204, Indio, CA 92201 | 2017-09-13 |
| 1154847234 | Myung Kee Park | Dentist | 81106 Ca-111, #c, Indio, CA 92201 | 2017-08-21 |
| 1912434937 | Mirage Home Health | Home Health | 82691 Miles Ave, Indio, CA 92201 | 2017-05-22 |
| 1497294821 | Orthopedic and Physical Medicine Associates Inc | Chiropractor | 81765 Hwy 111, #3, Indio, CA 92201 | 2017-02-17 |
| 1497103758 | Timothy Smith | Contractor | 81337 Avenida Romero, Indio, CA 92201 | 2016-05-27 |
| Find all providers in zip 92201 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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| 1295332633 | Compassionate Critical Care Group, Inc. | Internal Medicine | 22543 Ventura Blvd Ste 220, Woodland Hills, CA 91364-1403 | 2020-10-08 |
| 1972149748 | Bay Area Neurointensivists Inc | Internal Medicine | 3066 Deer Meadow Dr, Danville, CA 94506-2135 | 2019-11-26 |
| 1356903298 | Benjamin R Deaton Md Inc. | Internal Medicine | 7468 Muirwood Ct, Pleasanton, CA 94588-4232 | 2019-07-01 |
| 1851950232 | Riverside Medical Clinic Inc | Internal Medicine | 4100 Central Ave Ste 201, Riverside, CA 92506-2930 | 2019-06-10 |
| 1407414329 | Riverside Medical Clinic Inc | Internal Medicine | 2079 Compton Ave Ste A101, Corona, CA 92881-7284 | 2019-06-05 |
| 1144718875 | Jeffrey Tobias | Internal Medicine | 10 Lavender Ter, Petaluma, CA 94952-4938 | 2018-04-27 |
| 1780187229 | Jesse Robles | Internal Medicine | 651 Sunnyside Ave, San Diego, CA 92114-4945 | 2018-03-12 |
| 1710403183 | Excelcare | Internal Medicine | 2400 Chester Ave, Bakersfield, CA 93301-4020 | 2017-08-17 |
| 1255865549 | Liou Medical Inc | Internal Medicine | 17310 Evening Star Ave, Cerritos, CA 90703-8318 | 2017-04-13 |
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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.