KELSY DIETERICH (NPI# 1639660533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639660533 |
| Entity Type | Individual |
| Full Name | KELSY DIETERICH |
| Credential | CST/CSFA |
| Practice Address |
5100 Franklin Ave Ste C Waco TX 76710-6922 |
| Practice Telephone | 2547540375 |
| Practice Fax Number | 2547542667 |
| Mailing Telephone | 2547540375 |
| Mailing Fax Number | 2547542667 |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2018-05-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZS0410X |
Specialist/Technologist, Other Specialization: Surgical Technologist |
178624 | TX | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
5100 FRANKLIN AVE STE C |
| City | WACO |
| State | TX |
| Zip Code | 76710-6922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235417817 | Jeffrey S Blasick | Orthopaedic Surgery | 5100 Franklin Ave Ste C, Waco, TX 76710 | 2011-07-29 |
| 1477168706 | Hayden Joe Grimm | Physical Therapy Assistant | 5100 Franklin Ave Ste C, Waco, TX 76710-6922 | 2020-09-14 |
| 1538770664 | Kyndall M Brownsworth | Physical Therapist | 5100 Franklin Ave Ste C, Waco, TX 76710-6922 | 2020-08-12 |
| 1528606357 | Esmpt, LLC | Clinic/Center | 5100 Franklin Ave Ste C, Waco, TX 76710-6922 | 2019-12-11 |
| 1376185553 | Denise M Wise | Physical Therapist | 5100 Franklin Ave Ste C, Waco, TX 76710-6922 | 2019-10-09 |
| 1770969800 | Kristin L Hill | Nurse Practitioner | 5100 Franklin Ave Ste C, Waco, TX 76710-6922 | 2015-07-30 |
| 1750706347 | Total Trauma Care, Pllc | Family Medicine | 5100 Franklin Ave Ste C, Waco, TX 76710-6922 | 2014-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740741156 | Jessica Cook-lindsay | Physical Therapist | 2121 W Hwy 6, Waco, Waco, TX 76710 | 2019-03-28 |
| 1306354824 | Paula A Huffhines | Technician, Other | 115 S 25th, Waco, TX 76710 | 2018-01-18 |
| 1982154639 | Nha Do | Pharmacist | 1301 Wood Acres, Waco, TX 76710 | 2016-10-06 |
| 1649662495 | Pediatric Advanced Life Services Home Health LLC | Home Health | 3640 W Waco Dr, Waco, TX 76710 | 2015-03-02 |
| 1881008795 | Soumava Sen, Dds, P.C. | Dentist | 4215 Franklin Ave, Ste. 300, Waco, TX 76710 | 2014-06-18 |
| 1053742221 | Dustin Dwain Kelm | Physical Therapist | 5400 Laurel Dr., Waco, TX 76710 | 2013-12-12 |
| 1881038776 | Penelope Diane Lane | Counselor | 7524 Bosque, Waco, TX 76710 | 2013-04-22 |
| 1538400627 | Erik Alexander Pernes Caluscusao | Physical Therapist | 415 Owen Ln Apt 911, Waco, TX 76710 | 2013-03-14 |
| 1447509039 | Sheree L Mach | Occupational Therapist | 5400 Laurel Lake Dr., Waco, TX 76710 | 2012-08-29 |
| 1568738425 | Ramanathan Anandaraman | Internal Medicine | 2608 Skyline Drive, Waco, TX 76710 | 2012-03-26 |
| Find all providers in zip 76710 | ||||
| Taxonomy Code | 246ZS0410X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Technologist |
| Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. |
| Notes: Source: Association of Surgical Technologists, "Job Description: Surgical Technologist," 2014. [7/1/2014: code modified, title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972075323 | Irvingverse Iom LLC | Specialist/Technologist, Other | 803 Little Cub Way, Euless, TX 76039 | 2018-12-26 |
| 1346751039 | Sergio Nmn Villarreal | Specialist/Technologist, Other | 3505 San Esteban St, Mission, TX 78572-7509 | 2017-10-20 |
| 1457876864 | Fort Worth Csn Monitoring Pllc | Specialist/Technologist, Other | 3516 Ranch View Ter, Fort Worth, TX 76109-3130 | 2017-08-07 |
| 1124564406 | Laura Lopez | Specialist/Technologist, Other | 5511 Pecan Spgs, Apt#10304, San Antonio, TX 78249-5300 | 2017-01-11 |
| 1366999484 | Paul Espeseth | Specialist/Technologist, Other | 7324 Sw Freeway, Suite 1550, Houston, TX 77074 | 2016-09-07 |
| 1578916052 | Derek Demone Evans | Specialist/Technologist, Other | 1132 Highcrest Dr, Burleson, TX 76028-7464 | 2016-07-19 |
| 1194184564 | Monitoring Concepts Iom Group | Specialist/Technologist, Other | 4536 Lovers Lane, Ste 410, Dallas, TX 75225 | 2016-02-15 |
| 1861866915 | Alliance Iom, LLC | Specialist/Technologist, Other | 1801 Royal Ln, 908, Farmers Branch, TX 75229-3179 | 2015-11-30 |
| 1427421874 | Jasmine Payro | Specialist/Technologist, Other | 8657 Star Thistle Dr, Fort Worth, TX 76179-4388 | 2015-11-06 |
| 1275905432 | Synapses Neurowatch Corp | Specialist/Technologist, Other | 111 Boland Street, Ste 211, Ft. Worth, TX 76107-1268 | 2015-10-28 |
| 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.