MR. SHANE WILSON (NPI# 1669952966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669952966 |
| Entity Type | Individual |
| Full Name | MR. SHANE WILSON |
| Practice Address |
1522 S Tyler St Little Rock AR 72204 |
| Mailing Address |
1522 S Tyler St Little Rock AR 72204-2784 |
| Practice Telephone | 5015150828 |
| Mailing Telephone | 5013529825 |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982009569 | Shane Michael Wilson | Chiropractor | 938 Wrens Roost Cir, 2, Memphis, TN 38119-0510 | 2014-10-25 |
| 1063742138 | Shane Ray Wilson | Counselor | 2820 Weymouth Way, Norman, OK 73071-7269 | 2010-01-12 |
| 1902440035 | Shane Marcus Wilson | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1437624236 | Shane David Wilson | Nurse Practitioner | 1249 15th St Ste 4000, Huntington, WV 25701-3663 | 2018-10-08 |
| 1477808467 | Shane Charles Wilson | Internal Medicine | 450 E Sigler Ave, Ste A, Memphis, MO 63555-1726 | 2012-07-17 |
| 1245548239 | Shane Wilson | Rehabilitation Practitioner | 741 Rancho Via Dr, Sparks, NV 89434-4051 | 2010-09-23 |
| 1336314392 | Shane Wilson | Counselor | 1470 W Herndon Ave, Suite 300, Fresno, CA 93711-0552 | 2008-04-29 |
| Street Address |
1522 S TYLER ST |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1275056004 | University of Arkansas for Medical Sciences | Orthopaedic Surgery | 108015 Colonel Glenn Rd, Little Rock, AR 72204 | 2017-07-24 |
| 1265954820 | Marilyn Marie Lynch | Registered Nurse | 7723 Colonel Glenn Road, Little Rock, AR 72204 | 2017-07-14 |
| 1962852954 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1122 S. University Ave, Little Rock, AR 72204 | 2016-06-21 |
| 1841607751 | Charity Gillespie | Registered Nurse | 5210 Timberland Dr, Little Rock, AR 72204 | 2014-07-14 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1548696065 | Jamie Washington | Prosthetic/Orthotic Supplier | 4701 Westwood Ave, Little Rock, AR 72204 | 2013-09-16 |
| 1124468913 | Stephanie Rachelle Jez | Genetic Counselor, MS | 5800 West 10th Street, Freeway Medical Building, Suite 7-500, Little Rock, AR 72204 | 2013-06-26 |
| 1336492321 | Alton Charles Phillips Sr. | Counselor | 4400shuffield Drive, Little Rock, AR 72204 | 2012-10-16 |
| 1831446483 | Mattie Michelle Norman | Case Manager/Care Coordinator | 2124 Labette, Apt. N23, Little Rock, AR 72204 | 2012-08-13 |
| Find all providers in zip 72204 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518579457 | L&j Empowerment Inc | Non-emergency Medical Transport (VAN) | 701 W 7th St Ste 201, Little Rock, AR 72201-4001 | 2020-08-21 |
| 1275175796 | City Ride LLC | Non-emergency Medical Transport (VAN) | 6504 Beacon St, Little Rock, AR 72207-3415 | 2019-10-16 |
| 1275184616 | Christopher Gregory | Non-emergency Medical Transport (VAN) | 9221 Vanderbilt Dr, Little Rock, AR 72204-4355 | 2019-09-26 |
| 1508410648 | Heaven Sent Adult Daycare Center | Non-emergency Medical Transport (VAN) | 5 Innwood Cir Ste 110, Little Rock, AR 72211-2499 | 2019-07-26 |
| 1770097818 | Doug Simmons Jr. | Non-emergency Medical Transport (VAN) | 3005 S State St, Little Rock, AR 72206-3071 | 2017-11-28 |
| 1770939639 | Timothy Akins | Non-emergency Medical Transport (VAN) | 4 Bellemeade Dr, Little Rock, AR 72204-4842 | 2016-05-10 |
| 1447606538 | C&k Transportation Service, LLC | Non-emergency Medical Transport (VAN) | 10 Warren Dr, Little Rock, AR 72209-7749 | 2016-05-09 |
| 1245686336 | American Mobile Transportation, LLC | Non-emergency Medical Transport (VAN) | 13011 Stacy Ln, Little Rock, AR 72211-3238 | 2016-05-09 |
| 1699121608 | Bj Transportation | Non-emergency Medical Transport (VAN) | 12 Peach Tree Pl, Little Rock, AR 72204-8516 | 2016-05-09 |
| 1649626649 | A&b Transportation | Non-emergency Medical Transport (VAN) | 26 Villa Vista Loop, Little Rock, AR 72204-6708 | 2016-05-09 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72204 |
Please comment or provide details below to improve the information on MR. SHANE WILSON.
| 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.