DR. GREGORY CHARLES WILKENS (NPI# 1134214596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134214596 |
| Entity Type | Individual |
| Full Name | DR. GREGORY CHARLES WILKENS |
| Credential | M.D. |
| Practice Address |
515 Memorial Dr Ste 1 Manchester KY 40962-9157 |
| Mailing Address |
509 Memorial Dr Ste 2 Manchester KY 40962-6196 |
| Practice Telephone | 6065984534 |
| Practice Fax Number | 6065992524 |
| Mailing Telephone | 6065985104 |
| Mailing Fax Number | 6065980983 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-01-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 38097 | KY | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | MD0000035379 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3885392 | 05 | |
| KY | 64064413 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 131 Hospital Lane, Suite 1, Jellico, TN 37762 | 4237847269 | 4237843708 |
| 210 Marie Langdon Dr, Manchester, KY 409626388 | 6065985104 | 6065992524 |
| Street Address |
515 MEMORIAL DR STE 1 |
| City | MANCHESTER |
| State | KY |
| Zip Code | 40962-9157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003801689 | Utpal K Bhanja | Internal Medicine | 515 Memorial Dr Ste 1, Manchester, KY 40962-9157 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609392356 | Angela Woods | Speech-Language Pathologist | 96 Woods Rd, Manchester, KY 40962 | 2017-08-15 |
| 1346627296 | Betty Alevras | Nurse Practitioner | 21 Crestview Drive, 204 Town Branch Road, Manchester, KY 40962 | 2015-04-29 |
| 1740525773 | Clay Community Pharmacy LLC | Pharmacy | 118 Clay Co S/c, Manchester, KY 40962 | 2012-12-03 |
| 1669758579 | Becky F Stubblefield | Nurse Practitioner | 65 Glenndale Drive, Manchester, KY 40962 | 2011-10-25 |
| 1891022315 | Sabrina Nicole Hacker | Occupational Therapist | 376 Manchester Square Shopping Centre, Manchester, KY 40962 | 2009-11-04 |
| 1114102167 | H&n Drug | Durable Medical Equipment & Medical Supplies | 515 Memorial Dr., Suite 2, Manchester, KY 40962 | 2008-01-08 |
| 1598944043 | Cumberland Valley Dist. Health Dept | Public Health or Welfare | 1983 Hwy 421, Manchester, KY 40962 | 2007-11-01 |
| 1023223203 | Dinah Lynn Sowders | Speech-Language Pathologist | 561 Mill Pond Drive, Manchester, KY 40962 | 2007-05-11 |
| 1104965300 | American Health Management, Inc. | Case Management | 2609 Hwy 80, Manchester, KY 40962 | 2007-02-05 |
| 1306902572 | Manchester Pharmacist Group LLC | Durable Medical Equipment & Medical Supplies | 415 Richmond Road, Unit B, Manchester, KY 40962 | 2006-12-29 |
| Find all providers in zip 40962 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639618663 | Heather N Fesmire | Surgery | 1030 Mcarthur St., Manchester, TN 37355 | 2017-02-23 |
| 1013279199 | Eyone Jones | Surgery | 29 Haynes St Ste B, Manchester, CT 06040-4139 | 2012-06-13 |
| 1982721866 | William S. Karkow | Surgery | 2582 150th Ave, Manchester, IA 52057-8524 | 2007-03-23 |
| 1205912102 | Manchester Surgical Assoc | Surgery | 1239 Mcarthur Drive, Manchester, TN 37355-2423 | 2006-10-31 |
| 1598873259 | Ja-nan Yu | Surgery | 1050 Mcarthur Street, Manchester, TN 37349 | 2006-08-25 |
| 1457388183 | Laureen Forgione-rubino | Surgery | 945 Main Street, Suite #105, Manchester, CT 06040 | 2006-06-27 |
| 1568423846 | Marc S Rubenson | Surgery | 125 Chase Way, Manchester, NH 03104-1717 | 2006-03-28 |
| 1225004005 | Edward P. Dalton | Surgery | Elliot Breast Health Center, 275 Mammoth Road, Suite 1, Manchester, NH 03109 | 2006-02-23 |
| 1861465635 | Reginald Winfield Raynor IIi | Surgery | 29 Haynes St, Suite B, Manchester, CT 06040-4139 | 2006-02-10 |
| 1710976964 | Lawrence Michael Hoepp | Surgery | 184 Tarrytown Rd, Manchester, NH 03103-2713 | 2005-10-20 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 40962 |
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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.