KEVIN WILLIAM SMALLWOOD (NPI# 1336283803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336283803 |
| Entity Type | Individual |
| Full Name | KEVIN WILLIAM SMALLWOOD |
| Credential | PA-C |
| Practice Address |
4755 Ogletown-stanton Dr Suite 1e50 Newark DE 19718 |
| Mailing Address |
4755 Ogletown-stanton Rd, Suite 1e50 Newark DE 19718 |
| Practice Telephone | 3027331980 |
| Practice Fax Number | 3027331986 |
| Mailing Telephone | 3027331980 |
| Mailing Fax Number | 3027331986 |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2008-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | C0001161 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | CS-0000589 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C0001161 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4755 OGLETOWN-STANTON DR SUITE 1E50 |
| City | NEWARK |
| State | DE |
| Zip Code | 19718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679026272 | Vikashsingh Parshin Rambhujun | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Road, Suite 2875, Newark, DE 19718 | 2016-07-29 |
| 1730536053 | David Nathan Levine | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, Christiana Health Care, Newark, DE 19718 | 2016-05-17 |
| 1831570332 | Waqas Abid | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, S-le45, Newark, DE 19718 | 2015-06-11 |
| 1366886368 | Amanda J Taylor | Family Medicine | 4755 Ogletown Stanton Rd Ste 6e34, Newark, DE 19718 | 2013-04-20 |
| 1114360872 | Kalpana Suresh | Surgery | 4755 Ogletown-stanton Rd., Newark, DE 19718 | 2013-04-12 |
| 1568580769 | Ember L. Crevar | Pediatrics | 4755 Ogletown Stanton Rd., Christiana Care Hospital - Dept. of Pediatrics, Newark, DE 19718 | 2007-03-26 |
| 1023066404 | Samuel G Putnam IIi | Radiology | 4755 Ogletown Santon Road, Suite 1e20, Newark, DE 19718 | 2006-05-05 |
| 1053374181 | Hung Quang Dam | Nuclear Medicine | Nuclear Medicine, 4755 Ogletown-stanton Rd, Newark, DE 19718 | 2006-04-10 |
| 1346211018 | Robert Flinn | Internal Medicine | 4655 Ogletown-stanton Road, Suite 5343, Newark, DE 19718 | 2006-01-30 |
| 1861477390 | Janet G. Dutcher | Nurse Practitioner | 4755 Ogletown - Stanton Road, Room 2990, Newark, DE 19718 | 2005-12-07 |
| Find all providers in zip 19718 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992104962 | Jessica Nackley | Physician Assistant | 1200 Driving Park Ave Ste 4, Newark, NY 14513-1090 | 2014-08-15 |
| 1831304682 | Geraldine Redmond | Physician Assistant | 150 Bergen St., E - Level Rm# E346, Newark, NJ 07103 | 2007-05-14 |
| 1285856716 | Jill Rachel Mermagen | Physician Assistant | 4755 Stanton Ogletown Road, Newark, DE 19711 | 2007-05-03 |
| 1679794473 | North Jersey Orthopaedic Group | Physician Assistant | 90 Bergen St Ste 1200, Newark, NJ 07103-2425 | 2007-05-01 |
| 1073697330 | Krista Wark Rogaski | Physician Assistant | 90 Bergen St # 8100, Newark, NJ 07103-2425 | 2006-10-24 |
| 1043310527 | Anthony H Hamded | Physician Assistant | 111 Central Ave Fl 3, Newark, NJ 07102-1909 | 2006-09-24 |
| 1922614981 | Kalette Demarrais | Physician Assistant | 1096 Old Churchmans Rd, Newark, DE 19713-2102 | 2020-09-16 |
| 1477162725 | Aidan Sullivan | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-23 |
| 1871064352 | Cassandra Barker | Physician Assistant | 150 Bergen St, Newark, NJ 07103-2496 | 2018-12-10 |
| 1881161198 | Kaitlyn A Tytka | Physician Assistant | 1200 Driving Park Ave Ste 4, Newark, NY 14513-1090 | 2018-10-25 |
| Find all providers in NEWARK | ||||
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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.