DR. CARL R WILLE (NPI# 1154310506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154310506 |
| Entity Type | Individual |
| Full Name | DR. CARL R WILLE |
| Credential | MD |
| Practice Address |
51 Woodruff St Saranac Lake NY 12983-1715 |
| Practice Telephone | 5188918412 |
| Practice Fax Number | 5188915396 |
| Mailing Telephone | 5188918412 |
| Mailing Fax Number | 5188915396 |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 103981 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BW1289479 | 01 | |
| WC | 1039817 | 01 | |
| BC UTICA | 107286 | 01 | |
| NY | EMPIRE BLUE CROSS | 493301 | 01 |
| MVP SELECT CARE | 985413 | 01 | |
| NY | 00727151 | 05 | |
| NY | BLUE SHIELD OF NORTHEASTE | 000406324001 | 01 |
| LICENSE | 103981 | 01 |
| Street Address |
51 WOODRUFF ST |
| City | SARANAC LAKE |
| State | NY |
| Zip Code | 12983-1715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699987677 | Kim Dickinson | Technician/Technologist | 51 Woodruff St, Saranac Lake, NY 12983-1715 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013486315 | Aisha Dominique Wood | Physical Therapist | 2233 Ny-86, Saranac Lake, NY 12983 | 2018-11-15 |
| 1215357132 | Ashley Garwood | Occupational Therapist | 38 Tahoma Road, Saranac Lake, NY 12983 | 2014-04-17 |
| 1841537982 | Dean Everritt | Social Worker | 33 Depot St., Saranac Lake, NY 12983 | 2013-01-09 |
| 1265797013 | Danielle Carr | Counselor | 28 Bernard Street, Saranac Lake, NY 12983 | 2012-07-09 |
| 1275807489 | Deborah Ann Stevens | Licensed Practical Nurse | 157 Bloomingdale Ave Apt 3, Saranac Lake, NY 12983 | 2012-03-06 |
| 1699085910 | Jessica Evans Jakobe | Speech-Language Pathologist | 141 Petrova Ave, Petrova Elementary, Saranac Lake, NY 12983 | 2010-10-20 |
| 1548407562 | Eve M Burns | Obstetrics & Gynecology | 309 County Route 47 Ste 2, Saranac Lake, NY 12983 | 2009-01-13 |
| 1174735492 | Citizen Advocates Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6 Shepard Ave Apt. 1, Saranac Lake, NY 12983 | 2007-05-07 |
| 1750442513 | High Peaks Hospice and Palliative Care, Inc. | Hospice Care, Community Based | 309 County Route 47 Ste 7, Saranac Lake, NY 12983 | 2006-12-13 |
| 1467536797 | Clifford Gerard Wagner | Chiropractor | 53 Woodruff Street, Saranac Lake, NY 12983 | 2006-10-24 |
| Find all providers in zip 12983 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013489673 | Nicole Bureau | Specialist | 26 Trudeau Rd, Saranac Lake, NY 12983-5637 | 2018-12-20 |
| 1689074650 | Adirondack Gastrointestinal and Colorectal Surgery Pllc | Specialist | 2249 State Route 86 Ste 2, Saranac Lake, NY 12983 | 2014-08-27 |
| 1669801080 | James G Merrick M. D Pllc | Specialist | 309 County Route 47, Suite 1, Saranac Lake, NY 12983-5405 | 2013-11-06 |
| 1821210352 | Mountain Medical Pediatrics | Specialist | 1927 Saranac Ave, Saranac Lake, NY 12983 | 2007-05-03 |
| 1871645705 | Mountain Medical Services | Specialist | 354 Broadway, Saranac Lake, NY 12983-1146 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639099 | Munisa Mukhamatkulova | Specialist | 1133 E 73rd St, Brooklyn, NY 11234-5409 | 2020-11-06 |
| 1881295681 | Kirsten Skidmore | Specialist | 5924 Cleary Rd, Livonia, NY 14487-9726 | 2020-11-06 |
| 1740881846 | Deborah Singer X | Specialist | 6 Equestrian Ln Apt 8, Saratoga Springs, NY 12866-1053 | 2020-11-04 |
| 1619578929 | Ann Marie Spratt | Specialist | 3248 Sentinel Heights Road, Lafayette, NY 13084 | 2020-11-03 |
| 1215538863 | New Era Diagnostics Inc | Specialist | 8815 168th St, Suite 1r, Jamaica, NY 11432-4305 | 2020-11-02 |
| 1699376251 | Ilona Gamer | Specialist | 2525 E 23rd St, Brooklyn, NY 11235-2505 | 2020-11-02 |
| 1891395463 | Mk Star Inc | Specialist | 104 Linwood Ave, Staten Island, NY 10305-4400 | 2020-10-31 |
| 1649870981 | David Abrahams | Specialist | 22016 138th Ave, Laurelton, NY 11413-2325 | 2020-10-27 |
| 1477152122 | Kevin D Spencer | Specialist | 12027 Nashville Blvd Apt 1, Saint Albans, NY 11412-3829 | 2020-10-23 |
| 1356940167 | Jacqueline Belinda Trichter | Specialist | 1400 Old Old Country Rd, Suite C103n, Westbury, NY 11590 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | SARANAC LAKE |
| Zip Code | 12983 |
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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.