BRETT LEE WILSON (NPI# 1194726307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194726307 |
Entity Type | Individual |
Full Name | BRETT LEE WILSON |
Credential | PA |
Practice Address |
2521 Glenn Hendren Dr Ste 204 Liberty MO 64068-3388 |
Mailing Address |
1733 County Road 200 Emporia KS 66801-7672 |
Practice Telephone | 8167816066 |
Mailing Telephone | 6203438044 |
Enumeration Date | 2005-08-10 |
Last Update Date | 2019-06-19 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208600000X | Surgery | 15-00245 | KS | Allopathic & Osteopathic Physicians |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2009014905 | MO | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KS | 100002860A | 05 | |
MO | BCBS | 50797021 | 01 |
KS | PALMETTO RR MEDICARE | 970000628 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
2522 W 15th Ave, Emporia, KS 668016102 | 6203437043 | 6203438571 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053928804 | Brett M Wilson | Nurse Practitioner | 2030 Nw 5th Ter, Cape Coral, FL 33993-7536 | 2020-09-25 |
1881662963 | Brett Wilson | Family Medicine | 601 Handeyside Ln, Fort Atkinson, WI 53538-1273 | 2006-03-14 |
1699759175 | Brett Michael Wilson | Dentist | 5227 S Main St, Ste D, Joplin, MO 64804-4916 | 2005-11-30 |
1770101032 | Brett M Wilson | Dentist | 2999 Corporate Ln, Suffolk, VA 23434-8478 | 2020-07-13 |
1720645518 | Brett Wilson | Behavior Technician | 16200 19 Mile Rd, Clinton Township, MI 48038-1103 | 2019-05-28 |
1265818918 | Brett Wilson | Physical Therapy Assistant | 6106 Health Center Ln, Fredericksburg, VA 22407-6687 | 2015-08-05 |
1386025963 | Brett Allen Wilson | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2015-06-09 |
1164839031 | Brett Wilson | Nurse Practitioner | 541 State Route 664 N, Suite C, Logan, OH 43138-8541 | 2014-07-12 |
1922390947 | Brett Lonnis Wilson | Counselor | 2002 S Fillmore St, Little Rock, AR 72204-4909 | 2011-05-10 |
1780601252 | Brett Wilson II | Emergency Medicine | 300 W Pueblo St, Santa Barbara, CA 93105-4311 | 2006-07-17 |
Street Address |
2521 GLENN HENDREN DR STE 204 |
City | LIBERTY |
State | MO |
Zip Code | 64068-3388 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730490491 | Andrew J Taiber | Orthopaedic Surgery | 2521 Glenn Hendren Dr Ste 204, Liberty, MO 64068-3388 | 2010-06-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700437258 | Midwestern Medical Consultants LLC | Assisted Living Facility | 227 W. Franklin St, Liberty, MO 64068 | 2019-09-26 |
1063935062 | Jennifer Nichole Gibson | Nurse Practitioner | Liberty Hospital 2525 Glen Hendren Dr, Liberty, MO 64068 | 2017-07-21 |
1598288755 | Lhlc Operations, LLC | Skilled Nursing Facility | 2609 Glenn Hendren Dr Ste G100, Liberty, MO 64068 | 2017-07-19 |
1023438371 | Sarah E Ehlers | Social Worker | 1170 W. Kansas Ave, Bldg 10, Liberty, MO 64068 | 2014-04-24 |
1629498563 | Kelli Hedgpeth | Physical Therapy Assistant | 3980 South Jackson Dr, Independence, MO 64068 | 2014-04-18 |
1639593965 | Klein Dental Group LLC | Clinic/Center | 12 Westwoods Dr, Liberty, MO 64068 | 2014-02-06 |
1124457239 | Sarah Ehlers, Lcsw LLC | Social Worker | 1170 W Kansas Ave, Bldg 10, Liberty, MO 64068 | 2013-11-08 |
1134561558 | Holly Hemphill | Marriage & Family Therapist | 117 N. Water Street, Liberty, MO 64068 | 2013-07-26 |
1093157133 | Tina Wilma Sanborn | Marriage & Family Therapist | 1170 W. Kansas St., Liberty, MO 64068 | 2013-07-17 |
1609215441 | Timothy Adam Lynch | Marriage & Family Therapist | 1170 West Kansas Ave., Liberty, MO 64068 | 2013-06-14 |
Find all providers in zip 64068 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891806568 | Leigh Ann Johnson | Physician Assistant | 2521 Glenn Hendren Dr, Suite 308, Liberty, MO 64068-3388 | 2006-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184259079 | Dustin Edward Hemker | Physician Assistant | 937 Blake Ct, Saint Peters, MO 63376-5527 | 2020-03-11 |
1730669169 | Hannah Eagleburger | Physician Assistant | 4321 Wornall Rd, Ste 530, Kansas City, MO 64111 | 2018-08-15 |
1770073587 | Ashton Marie Roberts | Physician Assistant | 1 Hospital Dr # Dc077.00, Columbia, MO 65212-1000 | 2018-05-16 |
1295257285 | Katelynn Elizabeth Austin | Physician Assistant | 3250 Gordonville Rd Ste 384, Cape Girardeau, MO 63703-5095 | 2017-07-11 |
1407214364 | Kathryn Rebecca Bachman | Physician Assistant | 226 S Woods Mill Rd Ste 35w, Chesterfield, MO 63017-3442 | 2016-02-08 |
1699148429 | Michael Farrell | Physician Assistant | 7827 Highway N Ste 104, O Fallon, MO 63368-6704 | 2015-11-02 |
1427441492 | Cornerstone First Assisting | Physician Assistant | 267 Countryshire Dr, Lake St Louis, MO 63367-5823 | 2015-03-14 |
1205232915 | Pa Staffing LLC | Physician Assistant | 408 Ballwin Ave, Ballwin, MO 63021-5213 | 2014-11-06 |
1568702090 | Jamie Lyn Mertz | Physician Assistant | 9423 N Wayne Ct, Kansas City, MO 64155-2999 | 2013-02-20 |
1245586536 | Jeb Medical LLC | Physician Assistant | 1215 Clay St, Kansas City, MO 64116-4026 | 2012-07-24 |
Find all providers with the same taxonomy |
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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.