BRETT LEE WILSON


Address: 2521 Glenn Hendren Dr Ste 204, Liberty, MO 64068-3388
Phone: 8167816066

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
KS 100002860A 05
MO BCBS 50797021 01
KS PALMETTO RR MEDICARE 970000628 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
2522 W 15th Ave, Emporia, KS 668016102 6203437043 6203438571

Other Providers BRETT WILSON

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

Office Location

Street Address 2521 GLENN HENDREN DR STE 204
City LIBERTY
State MO
Zip Code 64068-3388

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730490491 Andrew J Taiber Orthopaedic Surgery 2521 Glenn Hendren Dr Ste 204, Liberty, MO 64068-3388 2010-06-28

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891806568 Leigh Ann Johnson Physician Assistant 2521 Glenn Hendren Dr, Suite 308, Liberty, MO 64068-3388 2006-08-31

Providers in the same taxonomy and state

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
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Competitor

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City LIBERTY
Zip Code 64068

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Dataset Information

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.

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