DR. KIM L. WIST (NPI# 1114046893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114046893 |
| Entity Type | Individual |
| Full Name | DR. KIM L. WIST |
| Other Name | KIM L. WIST-MANGAN |
| Credential | D.C. |
| Practice Address |
125 Sunrise Hwy West Islip NY 11795-2009 |
| Mailing Address |
1331 Waverly Ave Farmingville NY 11738-1354 |
| Practice Telephone | 6314220424 |
| Practice Fax Number | 6314221076 |
| Mailing Telephone | 6317368439 |
| Mailing Fax Number | 6314221076 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | X006556 | NY | Chiropractic Providers |
| Street Address |
125 SUNRISE HWY |
| City | WEST ISLIP |
| State | NY |
| Zip Code | 11795-2009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477634350 | Michael T Gray | Specialist | 125 Sunrise Hwy, West Islip, NY 11795-2023 | 2006-10-18 |
| 1033588926 | South Shore Infectious Diseases | Internal Medicine | 125 Sunrise Hwy, West Islip, NY 11795-2023 | 2015-09-21 |
| 1730496449 | Uzma Syed | Internal Medicine | 125 Sunrise Hwy, West Islip, NY 11795-2023 | 2010-09-02 |
| 1972772176 | Lenny Weinstein | Internal Medicine | 125 Sunrise Hwy, West Islip, NY 11795-2023 | 2008-02-21 |
| 1316152549 | Robert Steven Caires | Chiropractor | 125 Sunrise Hwy, West Islip, NY 11795-2009 | 2007-05-11 |
| 1225110695 | Adriane J Collins | Specialist | 125 Sunrise Hwy, West Islip, NY 11795-2023 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639790843 | Aparna Kaleeckal Rajalakshmi | Student in an Organized Health Care Education/Training Program | 1000 Montauk Highway, Good Samaritan Hospital Medical C, Attention Stephanie Rodriguez, Graduate Medical Educati, West Islip, NY 11795 | 2020-04-28 |
| 1164087375 | South Shore Medical Services Pllc | Physician Assistant | 1175 Montauk Kwy, Suite 6, West Islip, NY 11795 | 2019-05-02 |
| 1841656030 | Asnis Dental Pllc | Dentist | 440 Montauk Highway, West Islip, NY 11795 | 2016-01-05 |
| 1376913731 | Erik Walter | Physician Assistant | 434 Union Blvd, West Islip, NY 11795 | 2015-09-29 |
| 1902202302 | Cathleen Degarmo | Specialist | 524 Everdell Ave, West Islip, NY 11795 | 2014-11-12 |
| 1902201098 | Caitlin Henderson | Nurse Practitioner | 500 Montauk Highway Suite W, Sarah Schwartz Md Pllc, West Islip, NY 11795 | 2014-10-31 |
| 1497182752 | Alyssa C Cervini | Social Worker | 145 Higbie Ln, West Islip, NY 11795 | 2013-10-02 |
| 1174966485 | John George Egner | Specialist | 1 Kennedylane, W Islip, NY 11795 | 2013-04-17 |
| 1902155369 | Timothy George M.d., P.C. | Pediatrics | 239 Higbie Lane, West Islip, NY 11795 | 2012-08-31 |
| 1124387824 | Dawn Marie Coughlin | Speech-Language Pathologist | 50 Cedar Point Drive, West Islip, NY 11795 | 2012-05-15 |
| Find all providers in zip 11795 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053629741 | Frank Giantinoto | Chiropractor | 108 Higbie Ln, West Islip, NY 11795-3923 | 2010-09-16 |
| 1669606455 | Ceribelli Chiropractic, PC | Chiropractor | 1543 Madison Ave, West Islip, NY 11795-1722 | 2009-05-07 |
| 1962694885 | Jacqueline Dimalante Dc PC | Chiropractor | 720 Udall Road, West Islip, NY 11795 | 2007-08-14 |
| 1114117439 | Kostas Sclavos | Chiropractor | 720 Udall Rd, West Islip, NY 11795-1853 | 2007-08-01 |
| 1487711941 | Lawrence A Opisso | Chiropractor | 1253 Montauk Highway, West Islip, NY 11795-4916 | 2007-01-03 |
| 1114008042 | Anthony J Carrino | Chiropractor | 619 Montauk Hwy, West Islip, NY 11795 | 2006-10-18 |
| 1073629267 | Gail Fitzgerald | Chiropractor | 300 Willetts Ln, West Islip, NY 11795-4619 | 2006-08-22 |
| 1497869523 | Michael A Ercolino | Chiropractor | 250 Higbie Ln, West Islip, NY 11795-2828 | 2006-08-18 |
| 1639647837 | Jessica Grace Thalhamer | Chiropractor | 11 Thayer Pl, West Islip, NY 11795-4331 | 2018-11-06 |
| 1699077008 | South Main Chiropractic,p.c. | Chiropractor | 340 Montauk Hwy, Suite 2, West Islip, NY 11795-4437 | 2010-11-18 |
| Find all providers in WEST ISLIP | ||||
| City | WEST ISLIP |
| Zip Code | 11795 |
Please comment or provide details below to improve the information on DR. KIM L. WIST.
| 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.