MR. MATT P. PREWITT (NPI# 1023044898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023044898 |
Entity Type | Individual |
Full Name | MR. MATT P. PREWITT |
Credential | P.A.-C |
Practice Address |
2201 S Clear Creek Rd Killeen TX 76549-4110 |
Mailing Address |
100 High Trail Dr Georgetown TX 78633-4582 |
Practice Telephone | 2545198871 |
Mailing Telephone | 5757701530 |
Enumeration Date | 2006-06-24 |
Last Update Date | 2014-04-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA08154 | TX | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
98-PA17 | NM | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 25070363 | 05 |
Street Address |
2201 S CLEAR CREEK RD |
City | KILLEEN |
State | TX |
Zip Code | 76549-4110 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932107141 | Hector J Castro | Internal Medicine | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2005-07-12 |
1487265831 | Joanna Moldenhauer | Dietitian, Registered | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2020-08-10 |
1184234619 | Rebecca Joy Rubio | Dietitian, Registered | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2020-08-10 |
1619539145 | Jillian Christine Hudson | Nurse Practitioner | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2019-07-04 |
1215491717 | Nina Marie Wilson | Nurse Practitioner | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2019-01-29 |
1568946960 | Jordan Yuen | Occupational Therapist | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2018-09-20 |
1215418280 | Emergency Associates of Central Texas Pa | Physician Assistant | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2018-08-27 |
1386132942 | Alexandra Hung | Physician Assistant | 2201 S Clear Creek Rd, Killeen, TX 76549 | 2018-04-28 |
1114453693 | Austin Charles Miller | Hospitalist | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2017-05-03 |
1225579956 | Pamela Roy-kondepati | Internal Medicine | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2017-03-14 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023630191 | Joy Angolo | Registered Nurse | 1403 Chips Drive, Unit A, Killeen, TX 76549 | 2020-05-12 |
1215587308 | Jacqueline Nicole Estrella | Nurse Practitioner | Med Options Killeen Nursing Homes, Kileen, TX 76549 | 2019-09-19 |
1366924052 | Barbara Ann Vaughn | Licensed Vocational Nurse | 413 Apt A Study Hall Loop, Killeen, TX 76549 | 2018-08-30 |
1124505359 | Carl R Darnall Army Medical Center | Clinic/Center | 5200 Bunny Trail, Killeen, TX 76549 | 2018-07-20 |
1518456961 | Robert Brott | Counselor | 1103west Stan Schuleter Loop, Building A, Suite 100, Killeen, TX 76549 | 2018-05-01 |
1922507417 | Family Endeavors, Inc. | Community/Behavioral Health | 1103 West Stan Schlueter Loop, Building A Suite 100, Killeen, TX 76549 | 2018-02-09 |
1285143859 | Jennifer Dawn Rothman | Behavioral Analyst | 4506 The Searchers Dr, Killeen, TX 76549 | 2017-09-26 |
1700307964 | City of Ennis | Skilled Nursing Facility | 5000 Thayer Dr, Killeen, TX 76549 | 2017-06-28 |
1790216190 | Neysa Stegmeyer | Nurse Practitioner | 4102 S. Clear Creek Road, Ste 107, Killeen, TX 76549 | 2017-03-27 |
1740721471 | Lspd At Killeen, Pllc | Dentist | 1103 West Stan Schlueter Loop Suite B-800, Killeen, TX 76549 | 2017-03-14 |
Find all providers in zip 76549 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093063380 | Jennifer Ellen Young | Physician Assistant | 2301 S Clear Creek Rd Ste 206, Killeen, TX 76549-4119 | 2012-08-17 |
1033259155 | Dorothy Mae Thompson | Physician Assistant | 4310 Boots Dr, Killeen, TX 76549-2794 | 2007-02-07 |
1861556631 | Jeffrey A Brooks | Physician Assistant | 4400-3 E Central Texas Expy, Suite A, Killeen, TX 76543-7372 | 2006-12-19 |
1760042071 | Samantha Duran Mcgrade | Physician Assistant | 4501 S Clear Creek Rd, Killeen, TX 76549-4218 | 2019-06-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
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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.