DR. CORIN Q WILDE (NPI# 1285616375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285616375 |
| Entity Type | Individual |
| Full Name | DR. CORIN Q WILDE |
| Credential | DPM |
| Practice Address |
407 E Centennial Dr Pittsburg KS 66762-6505 |
| Practice Telephone | 6202315940 |
| Practice Fax Number | 6202315948 |
| Mailing Telephone | 6202315940 |
| Mailing Fax Number | 6202315948 |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2014-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2000168834 | MO | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
12-00315 | KS | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BLUE CROSS | 114056 | 01 |
| KS | 0638544 | UMWA | 01 |
| Street Address |
407 E CENTENNIAL DR |
| City | PITTSBURG |
| State | KS |
| Zip Code | 66762-6505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225253305 | Wilde Foot & Ankle Clinic Pa | Podiatrist | 407 E Centennial Dr, Pittsburg, KS 66762-6505 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578172250 | Mallory Kate Revell | Student in an Organized Health Care Education/Training Program | 1701 S Broadway S, Irene Ransom Bradley School of Nursing, Psu, Pittsburg, KS 66762 | 2020-07-28 |
| 1245849967 | Shelbie Cosby | Student in an Organized Health Care Education/Training Program | 1701 S. Broadway St, Irene Ransom Bradley School of Nursing, Pittsburg, KS 66762 | 2020-07-28 |
| 1679103642 | Jessica Crager | Nurse Practitioner | 2401 S Tucker Terr, Ste 1, Pittsburg, KS 66762 | 2020-01-18 |
| 1376198226 | Apollo Services Inc | Durable Medical Equipment & Medical Supplies | 2505 S Springdale, Pittsburg, KS 66762 | 2019-08-07 |
| 1851885719 | Chelsea Duncan | Social Worker | 911 E Centennial, Pittsburg, KS 66762 | 2018-06-14 |
| 1902395858 | Alexandria Winter | Specialist/Technologist | 1701 S Homer Street, Pittsburg, KS 66762 | 2018-05-07 |
| 1811419633 | Troy Richard Quenzer | Specialist/Technologist | 1701 S Homer St, 213 Weede Phys Ed Bldg, Pittsburg, KS 66762 | 2017-07-13 |
| 1356727002 | John Klodt | Social Worker | 902 E Centennial Dr Apt 13a, Pittsburg, KS 66762 | 2015-08-05 |
| 1295120533 | Christine E. Conner | Nurse Practitioner | 1 Mt. Carmel Way, 2nd Floor, East, Pittsburg, KS 66762 | 2015-04-03 |
| 1700278983 | Performance Spine & Sport LLC | Chiropractor | 2597 S. Broadway Suite A, Pittsburg, KS 66762 | 2015-02-25 |
| Find all providers in zip 66762 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225253305 | Wilde Foot & Ankle Clinic Pa | Podiatrist | 407 E Centennial Dr, Pittsburg, KS 66762-6505 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962859777 | David Sanchez | Podiatrist | 758 S Hillside St Ste 2, Wichita, KS 67211-3038 | 2016-05-21 |
| 1750752960 | Wichita Foot and Ankle Wound Center | Podiatrist | 220 S Hillside St Ste B, Wichita, KS 67211-2151 | 2015-10-14 |
| 1861788275 | Thomas Lyman | Podiatrist | 1230 E 6th Ave Ste 2a, Winfield, KS 67156-3145 | 2011-06-23 |
| 1790965564 | Comprehensive Foot Centers P.a. | Podiatrist | 503 Olive St, Leavenworth, KS 66048-2651 | 2007-11-09 |
| 1386844967 | Fornelli Feet Pa | Podiatrist | 7224 E Bainbridge Ct, Wichita, KS 67226-1140 | 2007-07-20 |
| 1194847947 | Ali R Davis | Podiatrist | 4601 W 109th St Ste 314, Overland Park, KS 66211 | 2007-04-04 |
| 1588765440 | Lawrence R. Gaston, Jr Dpm Pa | Podiatrist | 5100 Bob Billings Parkway, Suite 100, Lawrence, KS 66049-4094 | 2006-09-25 |
| 1770534299 | Dan Edward Robinson | Podiatrist | 4101 S 4th Trafficway, 112a, Leavenworth, KS 66048 | 2006-05-12 |
| 1154398527 | Smoky Valley Foot Center Pa | Podiatrist | 515 Ne 10th St, Abilene, KS 67410-2153 | 2006-03-03 |
| 1619976842 | Lawrence R Gaston Jr. | Podiatrist | 5615 Westfield Dr, Lawrence, KS 66049-3702 | 2005-07-19 |
| 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.