KEITH C WILSON (NPI# 1467604744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467604744 |
| Entity Type | Individual |
| Full Name | KEITH C WILSON |
| Credential | LSA |
| Practice Address |
2503 Robin Knoll Ct Fresno TX 77545-8167 |
| Practice Telephone | 2815092017 |
| Mailing Telephone | 2815092017 |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2016-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
SA00410 | TX | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982949988 | Keith L Wilson IIi | Counselor | 1330 E Cherry St # 12, Springfield, MO 65802-3429 | 2012-12-01 |
| 1609022219 | Keith Raymond Wilson | Counselor | 1596 Monroe Ave, Rochester, NY 14618-1415 | 2008-08-14 |
| 1346391976 | Keith Peter Wilson | Dentist | 211 N Second St, Po 727, Peotone, IL 60468-8837 | 2007-01-12 |
| 1578621769 | Keith Jonathan Wilson | Dentist | 10590 Enduring Freedom Dr, Us Army Dental Activity, Fort Drum, NY 13602-5005 | 2006-12-04 |
| 1205907615 | Keith Wilson | Chiropractor | 1717 Amwell Road, Somerset, NJ 08873 | 2006-11-10 |
| 1609307560 | Keith Wilson | Counselor | 8915 Sw Center St, Tigard, OR 97223-6307 | 2017-03-22 |
| 1851732697 | Keith Wilson | Prosthetic/Orthotic Supplier | 1823 Charlotte Ave, Nashville, TN 37203-2104 | 2013-07-09 |
| 1255776258 | Keith Garnett Wilson | Emergency Medicine | 155 N Fresno St, Fresno, CA 93701 | 2013-05-03 |
| 1720248198 | Keith D Wilson Jr. | General Practice | 11722 Reisterstown Rd, Reisterstown, MD 21136-3302 | 2008-06-10 |
| 1841470507 | Keith Alan Wilson | Physician Assistant | 12550 Hesperia Road, Suite100, Victorville, CA 92395-0000 | 2007-11-11 |
| Street Address |
2503 ROBIN KNOLL CT |
| City | FRESNO |
| State | TX |
| Zip Code | 77545-8167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114479466 | Dynamic Surgical Assistants of Texas | Specialist/Technologist, Other | 2503 Robin Knoll Ct, Fresno, TX 77545-8167 | 2016-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780100610 | Schristiandevelopment | Day Training, Developmentally Disabled Services | 3819 Teal Maple Ct., Fresno, TX 77545 | 2017-08-22 |
| 1548786924 | Katreece M Bell | Nurse Practitioner | 1834 Bravos Manor Lane, Fresno, TX 77545 | 2017-08-17 |
| 1275912735 | Evosource | Non-emergency Medical Transport (VAN) | 1307 Peacham Ct, Fresno, TX 77545 | 2015-05-29 |
| 1407241300 | Gwendolyn Champion | Physician Assistant | 4026 E Teal Estates Cir, Fresno, TX 77545 | 2015-03-30 |
| 1811394745 | Elaine Khuong | Pharmacist | 12225 Sr 6, Fresno, TX 77545 | 2014-11-20 |
| 1225442551 | Michael Jerome Tubbs | Specialist/Technologist, Other | 2126 Beacon Light Ln, Fresno, TX 77545 | 2014-06-14 |
| 1801219431 | Angelica Healthcare Services | Home Health | 3003 Valian Elm Street, Fresno, TX 77545 | 2014-02-03 |
| 1801048376 | Kroger Texas L P | Pharmacy | 10250 Fresno State Hwy 6, Fresno, TX 77545 | 2008-10-16 |
| 1215188818 | Kroger Texas Lp | Pharmacy | 10250 State Hwy 6, Fresno, CA 77545 | 2008-10-02 |
| 1528243201 | M & H Home Care Inc. | Home Health | 1335 Hunter Green Lane, Fresno, TX 77545 | 2007-12-31 |
| Find all providers in zip 77545 | ||||
| Taxonomy Code | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225442551 | Michael Jerome Tubbs | Specialist/Technologist, Other | 2126 Beacon Light Ln, Fresno, TX 77545 | 2014-06-14 |
| 1255772646 | Adam Coy Lacks | Specialist/Technologist, Other | 2115 Vermillion Oak St, Fresno, TX 77545-2063 | 2013-07-13 |
| 1114479466 | Dynamic Surgical Assistants of Texas | Specialist/Technologist, Other | 2503 Robin Knoll Ct, Fresno, TX 77545-8167 | 2016-11-02 |
| 1376901843 | Phenomsurgical Assisting | Specialist/Technologist, Other | 4026 E Teal Estates Cir, Fresno, TX 77545-8851 | 2016-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366791 | Erich Wittmer | Specialist/Technologist, Other | 2301 Links Dr, Edinburg, TX 78542-4542 | 2020-11-04 |
| 1366043705 | Patricia Vincenty-marquez | Specialist/Technologist, Other | 11308 Culberson Dr, Aubrey, TX 76227-8050 | 2020-11-03 |
| 1992306492 | Jennifer Suzanne Tatsch-gleason | Specialist/Technologist, Other | 7700 Floyd Curl Dr., San Antonio, TX 78229-3902 | 2020-11-03 |
| 1881294866 | Cynthia Alonzo | Specialist/Technologist, Other | 3800 Gaylord Pkwy Ste 410, Frisco, TX 75034-9419 | 2020-10-28 |
| 1356941652 | Synergistic Surgical Assistant | Specialist/Technologist, Other | 7414 Brookport, San Antonio, TX 78238-3528 | 2020-10-27 |
| 1225636103 | Daniel Martin Cornejo Navarro | Specialist/Technologist, Other | 25157 Resaca Santa Dr, San Benito, TX 78586-8889 | 2020-10-13 |
| 1497353593 | Jose De Jesus Alvarado Veloz | Specialist/Technologist, Other | 216 Mango Rd, El Paso, TX 79915-4314 | 2020-10-12 |
| 1639777824 | Eli Andres Pineda Faria | Specialist/Technologist, Other | 2218 Greenhouse Rd Apt 3224, Houston, TX 77084-7960 | 2020-10-11 |
| 1760089296 | Mark Evar Espiritu Ogbac | Specialist/Technologist, Other | 2119 Pacific Loon Lane, Conroe, TX 77385 | 2020-10-07 |
| 1871100735 | Helpinghandsbyterri, LLC | Specialist/Technologist, Other | 4050 Mcewen Rd Apt 18102, Dallas, TX 75244-5458 | 2020-09-24 |
| 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.