DR. BRENT WILSON (NPI# 1184647091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184647091 |
| Entity Type | Individual |
| Full Name | DR. BRENT WILSON |
| Credential | MD |
| Practice Address |
1303 E Herndon Ave Fresno CA 93720-3309 |
| Mailing Address |
Po Box 6089 Portland OR 97228-6089 |
| Practice Telephone | 5594503205 |
| Mailing Telephone | 8883981370 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | A84254 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | 00A842540 | 01 |
| CA | BLUE CROSS | A84254 | 01 |
| COUNTY OF FRESNO | A84254 | 01 | |
| CA | 00A842540 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811186034 | Brent A Wilson | Psychiatry & Neurology | 800 Peachtree St Ne, Apt 1303, Atlanta, GA 30308-1245 | 2007-10-24 |
| 1437661808 | Brent Andrew Wilson | Nurse Practitioner | 1453 Hope Way, Murfreesboro, TN 37129-3140 | 2017-10-25 |
| 1114461357 | Brent Wilson | Physician Assistant | 2460 Curtis Ellis Dr, Rocky Mount, NC 27804-2237 | 2016-12-07 |
| 1689060683 | Brent Wilson | Dietitian, Registered | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2015-04-07 |
| 1811307978 | Brent Alan Wilson | Counselor | 561 S 9th St, San Jose, CA 95112-3749 | 2014-04-29 |
| 1831121938 | Brent Donald Wilson | Internal Medicine | 30 N 1900 E, Room 4a100 Som, Salt Lake City, UT 84132-0002 | 2006-07-07 |
| 1760440879 | Brent C Wilson | Emergency Medicine | 4300 W Memorial Rd, Oklahoma City, OK 73120-8304 | 2006-05-01 |
| 1063491660 | Brent J Wilson | Optometrist | 2580 N Litchfield Rd, Goodyear, AZ 85395-2071 | 2006-01-11 |
| Street Address |
1303 E HERNDON AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93720-3309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528066560 | Andreas E Heller | Internal Medicine | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2005-07-13 |
| 1700484680 | Glenda Sherry Peveto | Nurse Practitioner | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2020-10-13 |
| 1407466485 | Terry Louise George | Physical Therapy Assistant | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2020-08-05 |
| 1255956546 | Maria Cecilia Unay Paredes | Nurse Practitioner | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2020-06-11 |
| 1770112054 | Chinedu Nwagwu | Student in an Organized Health Care Education/Training Program | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2020-04-07 |
| 1629613393 | Drnat Corp | Internal Medicine | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2019-11-16 |
| 1568014561 | Garrett Douglas Hicks | Nurse Practitioner | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2019-07-10 |
| 1407416480 | Gagandeep Kaur Khara | Nurse Practitioner | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2019-06-20 |
| 1689232449 | Forefront Radiology Medical Group PC | Radiology | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2019-06-05 |
| 1790341428 | Medeiros Md PC | Psychiatry & Neurology | 1303 E Herndon Ave, Fresno, CA 93720-3309 | 2019-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061129 | Ariel Lok Yen Leung | Student in an Organized Health Care Education/Training Program | 1313 East Herndon Ave, St 105, Fresno, CA 93720 | 2020-04-13 |
| 1457992513 | Brittany Nichole Willis | Audiologist | 1351 E Spruce Ave Ste 130, Fresno, CA 93720 | 2019-09-30 |
| 1013567668 | Taylor Courteney Cox | Physical Therapist | 7080 N. Maple Ave #101, Fresno, CA 93720 | 2019-09-16 |
| 1457909152 | Lillian M Augilera | Technician | 8419 N Dearing Ave, Fresno, CA 93720 | 2019-08-27 |
| 1215581764 | Sterling Hospitalist Medical Group, Inc. | Clinic/Center | 1191 E. Herndon Avenue Suite 103, Fresno, CA 93720 | 2019-08-01 |
| 1376006429 | Nancy Minh Thao Dang | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2019-04-06 |
| 1366904716 | Shankar Nair | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105., Fresno, CA 93720 | 2019-04-04 |
| 1861979544 | Powell Pediatric Dentistry Chestnut Partnership | Dentist | 7005 N. Chestnut Ave Ste 101, Fresno, CA 93720 | 2018-07-25 |
| 1669967311 | Sierra Pacific Orthopaedic Center Medical Group Inc | Specialist | 1270 E. Spruce, Fresno, CA 93720 | 2018-06-26 |
| 1689168700 | Vinita Vishnoi | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2018-06-21 |
| Find all providers in zip 93720 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952677155 | Sarah G Sifuentez | Emergency Medicine | 6148 N Delbert Ave, Fresno, CA 93722-2419 | 2012-04-02 |
| 1134420045 | Tetsuo Ted Shigyo | Emergency Medicine | 2763 W Wrenwood Ave, Fresno, CA 93711-2562 | 2010-11-09 |
| 1215174602 | Jason Christopher Tsukamaki | Emergency Medicine | 6355 N Rafael Ave, Fresno, CA 93711-0956 | 2009-01-07 |
| 1780868158 | Robert P. Hansen, Inc. | Emergency Medicine | 6721 N Willow Ave Ste 104, Fresno, CA 93710-5950 | 2007-12-20 |
| 1265626378 | Kanwar Partap Singh Gill | Emergency Medicine | 8408 N Ann Ave, Fresno, CA 93720-4987 | 2007-08-31 |
| 1366635484 | Oleh J Wolowodiuk | Emergency Medicine | 521 E Mariners Cir, Fresno, CA 93730-0848 | 2007-08-22 |
| 1508906405 | Badrinath Kulkarni | Emergency Medicine | 1570 E. Herndon Avenue, Fresno, CA 93720 | 2007-02-08 |
| 1447261144 | Jacob M. Khushigian | Emergency Medicine | 5431 E Lane Ave, Fresno, CA 93727 | 2006-08-10 |
| 1346275625 | Gene Wayne Kallsen | Emergency Medicine | 290 N Wayte Ln # 1800, Fresno, CA 93701-2124 | 2006-07-12 |
| 1295735538 | Michael David Cawdery | Emergency Medicine | 155 N Fresno St, Ucsf-fresno Dept of Emergency Medicine, Fresno, CA 93701-2302 | 2005-07-28 |
| Find all providers in FRESNO | ||||
Please comment or provide details below to improve the information on DR. BRENT WILSON.
| 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.