THAD W WILKEY (NPI# 1174513188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174513188 |
| Entity Type | Individual |
| Full Name | THAD W WILKEY |
| Credential | PA |
| Practice Address |
16111 N Brinson St Ste100 Nampa ID 83687-9203 |
| Practice Telephone | 2084677546 |
| Practice Fax Number | 2084677500 |
| Mailing Telephone | 2084677546 |
| Mailing Fax Number | 2084677500 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2015-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA280 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806348800 | 05 | |
| ID | BLUE SHIELD | 000010139188 | 01 |
| ID | BLUE CROSS | PANX1 | 01 |
| ID | BLUE SHIELD | 000010138646 | 01 |
| ID | RAILROAD MEDICARE | 970026445 | 01 |
| ID | BLUE CROSS | PACB4 | 01 |
| ID | BLUE SHIELD | 000010147742 | 01 |
| ID | BLUE CROSS | PACC2 | 01 |
| Street Address |
16111 N BRINSON ST STE100 |
| City | NAMPA |
| State | ID |
| Zip Code | 83687-9203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307447 | Current Physical Therapy Nampa LLC | Physical Therapist | 16150 N High Desert Street, Nampa, ID 83687 | 2020-02-10 |
| 1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
| 1750828513 | Daniel & Max, LLC | Optometrist | 1600 Karcher Rd, Nampa, ID 83687 | 2017-01-31 |
| 1578965422 | Jorge Domingo Reyes | Counselor | 5700 E. Franklin Rd., Suite 220-i, Nampa, ID 83687 | 2014-09-23 |
| 1619302080 | David Lyle Farris | Dentist | 16548 North Franklin Blvd., Nampa, ID 83687 | 2013-09-04 |
| 1871934547 | Ian Zafar Qureshi | Internal Medicine | 4400 E Flamingo Ave Ste 130, Nampa, ID 83687 | 2013-07-10 |
| 1457696783 | Laurel Evans | Specialist/Technologist | 850 W. St. Luke's Dr., Suite 215, Nampa, ID 83687 | 2012-11-27 |
| 1750641197 | Andrea Patricia Fitzer | Nurse Practitioner | 4400 E. Flamingo Ave, Nampa, ID 83687 | 2012-05-18 |
| 1679846182 | Ivony Case Management | Case Management | 811 12th Street, Ste. 2, Nampa, ID 83687 | 2012-02-14 |
| 1699043679 | Saltzer Medical Group, P.a. | Durable Medical Equipment & Medical Supplies | 9850 W St Lukes Drive, Nampa, ID 83687 | 2011-12-06 |
| Find all providers in zip 83687 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174096606 | Derek Scott Ahlstrom | Physician Assistant | 847 Parkcentre Way Ste 7, Nampa, ID 83651-1794 | 2019-01-08 |
| 1083197016 | Jocelyn Ashley Benton | Physician Assistant | 3908 E Flamingo Ave, Nampa, ID 83687-3102 | 2018-09-14 |
| 1376090985 | Stephen Michael Wren | Physician Assistant | 11035 W Karcher Rd, Nampa, ID 83651 | 2016-09-01 |
| 1952799009 | Leslie Arlene Lewis | Physician Assistant | 9850 St Lukes Dr Ste 215, Nampa, ID 83687-7912 | 2014-12-23 |
| 1598192676 | Louie Ward Beech | Physician Assistant | 1510 12th Ave, Ste 200, Nampa, ID 83686 | 2013-10-03 |
| 1629155809 | Kristin Lund Lewis | Physician Assistant | 9850 W St Lukes Dr Ste 129, Nampa, ID 83687-7912 | 2006-11-01 |
| 1043286222 | Mark A Granrud | Physician Assistant | 215 E Hawaii Avenue, Nampa, ID 83686 | 2006-02-27 |
| 1669002721 | Nicole Webb | Physician Assistant | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-01-16 |
| 1407493638 | Alison R Dekerchove | Physician Assistant | 1115 12th Ave Rd, Nampa, ID 83686-5738 | 2019-12-06 |
| 1871136978 | Katelyn Elyse Macdonald | Physician Assistant | 11035 Karcher Rd, Nampa, ID 83651-8200 | 2019-10-21 |
| Find all providers in NAMPA | ||||
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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.