MS. KENTOYA VENGA WILLIS (NPI# 1053814426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053814426 |
| Entity Type | Individual |
| Full Name | MS. KENTOYA VENGA WILLIS |
| Practice Address |
4504 Edinburgh Dr Tyler TX 75703-2303 |
| Practice Telephone | 9035397754 |
| Mailing Telephone | 9035397754 |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| Street Address |
4504 EDINBURGH DR |
| City | TYLER |
| State | TX |
| Zip Code | 75703-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003374190 | Monica Portillo | Technician | 13568 County Road 2241, Tyler, TX 75707-6616 | 2019-03-07 |
| 1225502974 | Sharon A Castleberry | Technician | 10973 County Road 2250, Tyler, TX 75707-4739 | 2019-01-16 |
| 1316999097 | New Concept Health Services, Inc | Technician | 620 Shelley Dr, Tyler, TX 75701-9438 | 2006-05-17 |
| 1427680982 | Emily Ann Phillps | Technician | 755 S Beckham Ave, Tyler, TX 75701-1903 | 2020-02-12 |
| 1174023014 | Maritzza Melendez | Technician | 755 S Beckham Ave, Tyler, TX 75701-1903 | 2018-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841301 | D&z Primary Home Care, LLC. | Technician | 2808 E Pauline Ln, Edinburg, TX 78542-2101 | 2020-11-05 |
| 1194326355 | Emma O. Franco | Technician | 708 3rd Street, Ozona, TX 76943 | 2020-11-04 |
| 1801497052 | Kizzie Ann Coleman | Technician | 7000 W. I-30 Apt. 836, Royse City, TX 75189 | 2020-11-04 |
| 1881294494 | Ifeoma Anita Ojukwu | Technician | 10440 South Dr Apt 506, Houston, TX 77099-2809 | 2020-11-01 |
| 1932709979 | Shannon Vinson | Technician | 12118 Parade Park Place, Houston, TX 77047-3534 | 2020-10-29 |
| 1881293439 | April Kay Gonzalez | Technician | 613 Montreal Ct, Brownsville, TX 78526-5136 | 2020-10-23 |
| 1467050484 | Lrv Group | Technician | 1905 S Arden St, Harlingen, TX 78552-7461 | 2020-10-12 |
| 1902403645 | Jireh Healthcare Services LLC. | Technician | 3000 N Mccoll Rd Ste 6, Mcallen, TX 78501-1476 | 2020-10-06 |
| 1285231399 | Texas Primary Home Care LLC | Technician | 701 Hidden Trce, Weslaco, TX 78599-4054 | 2020-10-02 |
| 1508473091 | Cielito Lindo Primary Home Care LLC | Technician | 8012 W Expressway 83 Ste B, Mission, TX 78572-2095 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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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.