KEITH WESTLEY SHILLITO (NPI# 1417954850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417954850 |
| Entity Type | Individual |
| Full Name | KEITH WESTLEY SHILLITO |
| Credential | M.D. |
| Practice Address |
905 Fiesta Parker AZ 85344-5152 |
| Practice Telephone | 9286692225 |
| Practice Fax Number | 9286696751 |
| Mailing Telephone | 9286692225 |
| Mailing Fax Number | 9286696751 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2014-02-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
32755 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ZP03006701 | 05 | |
| AZ | 480046 | 05 | |
| AZ | 862690 | 05 |
| Street Address |
905 FIESTA |
| City | PARKER |
| State | AZ |
| Zip Code | 85344-5152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568469906 | Parker Medical Center, Ltd. | Family Medicine | 905 Fiesta, Parker, AZ 85344-5152 | 2005-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689156366 | Kimberly Lynnette Kirkpatrick | Pharmacist | 12033 W Agency Ave, Parker, AZ 85344 | 2018-08-30 |
| 1811419534 | Cheryl Brooks | Registered Nurse | 12033 W. Agency Ave, Parker, AZ 85344 | 2017-07-14 |
| 1356877716 | Damian Jenkins | Specialist/Technologist, Other | 1200 S Mohave Ave, Parker, AZ 85344 | 2017-05-04 |
| 1821434184 | Rio Vista Surgical Associates P.C. | Surgery | 1200 Mohave Dr, Parker, AZ 85344 | 2013-05-14 |
| 1881039600 | Juan G Lopez | Counselor | 13376 1st Ave, Parker, AZ 85344 | 2013-05-07 |
| 1942581699 | Rocky Mountain Holdings LLC | Ambulance | 913 S Ocotillo Ave, Parker, AZ 85344 | 2011-09-07 |
| 1467732271 | Adam Caton | Podiatrist | 1713 S Kofa Ave Ste K, Parker, AZ 85344 | 2011-08-24 |
| 1902137516 | Shana Lee Tackett | Student in an Organized Health Care Education/Training Program | 12330 Agency Rd, Parker Indian Health Center, Parker, AZ 85344 | 2010-01-21 |
| 1649501339 | Alice Rodriguez | Student in an Organized Health Care Education/Training Program | 12330 Agency Rd., Parker, AZ 85344 | 2010-01-20 |
| 1821328931 | Armando Sosa Jr. | Student in an Organized Health Care Education/Training Program | 12330 Agency Road, Parker, AZ 85344 | 2010-01-12 |
| Find all providers in zip 85344 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568469906 | Parker Medical Center, Ltd. | Family Medicine | 905 Fiesta, Parker, AZ 85344-5152 | 2005-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326876 | Nicole Francisca Roberts | Family Medicine | 1449 S Monterey St, Gilbert, AZ 85233-8436 | 2020-11-08 |
| 1508496167 | Claudia Macias | Family Medicine | 4350 N 19th Ave Ste 3, Phoenix, AZ 85015-4602 | 2020-01-23 |
| 1992353312 | Az Premier Mobile Providers | Family Medicine | 2737 E Arizona Biltmore Cir Unit 30, Phoenix, AZ 85016-2170 | 2019-08-28 |
| 1558916247 | Shiny Susan Thomas | Family Medicine | 7615,east Baseline Road, Mesa, AZ 85209 | 2019-08-08 |
| 1508338732 | Erin Leah Mickelson | Family Medicine | 1542 Marvin Gardens Ln, Prescott, AZ 86301-5528 | 2018-12-28 |
| 1437698107 | Edward A Carrington Md Pllc | Family Medicine | 2600 E Southern Ave Ste F4, Tempe, AZ 85282-7626 | 2017-02-14 |
| 1396123733 | Vital Health Care LLC | Family Medicine | 7707 W Deer Valley Rd Ste 115, Peoria, AZ 85382-2101 | 2015-05-18 |
| 1609267038 | Annual Wellness Centers LLC | Family Medicine | 116 Lake Havasu Ave S Ste 103, Lake Havasu City, AZ 86403-0811 | 2015-02-06 |
| 1518386929 | Valor Health Services, LLC | Family Medicine | 2990 N Campbell Avenue, Suite 230, Tucson, AZ 85719 | 2014-04-14 |
| 1972940237 | Arizona City Health Associates, Inc. | Family Medicine | 13060 South Sunland Gin Road, Arizona City, AZ 85123 | 2013-05-28 |
| 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.