DR. KEVIN WILLIAM WILSON (NPI# 1790980381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790980381 |
| Entity Type | Individual |
| Full Name | DR. KEVIN WILLIAM WILSON |
| Credential | M.D. |
| Practice Address |
1700 Old Gatesburg Rd Ste 200 State College PA 16803-2276 |
| Practice Telephone | 8142374321 |
| Practice Fax Number | 8142350484 |
| Mailing Telephone | 8142374321 |
| Mailing Fax Number | 8142350484 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2019-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | MD468320 | PA | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
MD468320 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 285472538 | 9104504194 | 9104504194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033749031 | Kevin H Wilson | Social Worker | 30938 W Mitchell Dr, Buckeye, AZ 85396-6813 | 2020-01-19 |
| 1427548833 | Kevin Wilson | Dentist | 2034 Sturbridge Dr Apt B2, Columbus, OH 43209-4424 | 2018-05-11 |
| 1073037008 | Kevin M Wilson | Durable Medical Equipment & Medical Supplies | 2547 W Augusta Blvd # 4, Chicago, IL 60622-4561 | 2017-08-01 |
| 1275874356 | Kevin Jerome Wilson | Counselor | 970 E. 126th Terrace, Olathe, KS 66061 | 2013-03-14 |
| 1386965812 | Kevin Ford Wilson | Military Health Care Provider | 1 Wahoo Ave # 600, Groton, CT 06349-2324 | 2010-06-18 |
| 1437488749 | Kevin Poul Wilson | Counselor | 1819 N Dover St, Independence, MO 64058-1231 | 2009-12-15 |
| 1932368545 | Kevin Wilson | Physician Assistant | 1015 E 15th St, Plano, TX 75074-6221 | 2008-06-09 |
| 1073787776 | Kevin David Wilson | Family Medicine | 3801 N Mccoll Rd Apt 617, Mcallen, TX 78501-9141 | 2008-04-15 |
| 1649293531 | Kevin Drew Wilson | Dentist | 154 Elm St, Milford, NH 03055-4759 | 2006-07-25 |
| 1104890128 | Kevin David Wilson | Physical Therapist | 2835 Miami Village Dr, Miamisburg, OH 45342-4587 | 2006-02-15 |
| Street Address |
1700 OLD GATESBURG RD STE 200 |
| City | STATE COLLEGE |
| State | PA |
| Zip Code | 16803-2276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427077197 | Nathaniel L. Pozniak | Physician Assistant | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2006-07-19 |
| 1629625173 | Nathan C Wolcott | Physician Assistant | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2019-08-20 |
| 1932664281 | Aidin Kashigar | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2019-01-31 |
| 1023488871 | Scott M Minor | Physician Assistant | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2015-10-05 |
| 1003229998 | Brian T. Reid | Physician Assistant | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803 | 2014-06-09 |
| 1477730398 | Martin & Suhey Orthopedics, P.C. | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2008-01-22 |
| 1861694853 | Brian Allen Spencer | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803 | 2007-06-03 |
| 1306941562 | James S Martin | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2006-09-13 |
| 1730284910 | Paul V Suhey | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851581 | Tammy Lynn Terosky | Massage Therapist | 2134 Sandy Drive, Suite 6, State College, PA 16803 | 2020-08-12 |
| 1548748973 | Molly Gomez | Occupational Therapist | 260 Lions Hill Road, State College, PA 16803 | 2018-07-28 |
| 1568981827 | David Scott Kautz | Pharmacist | 1665 North Atherton Place, State College, PA 16803 | 2017-09-18 |
| 1245751023 | Zenovia Tarmohamed | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, Penn State Health At Mount Nittany Medical Center, State College, PA 16803 | 2017-06-30 |
| 1407205362 | Alka Sood | Student in an Organized Health Care Education/Training Program | 1850 E. Park Avenue, State College, PA 16803 | 2016-06-10 |
| 1588018766 | Daniel Frankel | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, State College, PA 16803 | 2016-04-14 |
| 1154791903 | Megan Widener | Physician Assistant | 2520 Green Tech Dr., Ste. D, State College, PA 16803 | 2015-10-05 |
| 1114301330 | Phuong Tran Courtney | Physician Assistant | 1613 North Atherton Street, Suite B, State College, PA 16803 | 2015-07-17 |
| 1164806840 | Amit Thatte | Student in an Organized Health Care Education/Training Program | 1850 East Park Ave., Suite 207, Penn State Hershey Medical Group, State College, PA 16803 | 2015-07-13 |
| 1245588946 | Phoenix Rehabilitation and Health Services, Inc. | Chiropractor | 1700 Old Gatesburg Road, Suite 210, State College, PA 16803 | 2012-08-28 |
| Find all providers in zip 16803 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790062578 | Philip Gwynne Roberts Jr. | Orthopaedic Surgery | 576 E Shadow Ln, State College, PA 16803-1227 | 2011-11-08 |
| 1376648543 | Kenneth L Cherry | Orthopaedic Surgery | 476 Rolling Drive Drive, Suite 200, State College, PA 16801 | 2006-09-13 |
| 1427036466 | James W Serene | Orthopaedic Surgery | 150 Brandywine Dr, State College, PA 16801-7972 | 2006-01-09 |
| 1932664281 | Aidin Kashigar | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2019-01-31 |
| 1669957916 | Sreenivasulu Metikala | Orthopaedic Surgery | 1850 E Park Ave Ste 112, State College, PA 16803 | 2018-10-02 |
| 1205186285 | University Orthopedics Center, Ltd | Orthopaedic Surgery | 476 Rolling Ridge Dr, Suite 200, State College, PA 16801-7639 | 2012-09-17 |
| 1558655308 | Casey Reade Antholz | Orthopaedic Surgery | 101 Regent Ct, State College, PA 16801-7965 | 2011-06-08 |
| 1477730398 | Martin & Suhey Orthopedics, P.C. | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2008-01-22 |
| 1417153768 | Paul K Herickhoff | Orthopaedic Surgery | 1850 E Park Ave Ste 112, State College, PA 16803-6706 | 2007-06-25 |
| 1861694853 | Brian Allen Spencer | Orthopaedic Surgery | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803 | 2007-06-03 |
| Find all providers in STATE COLLEGE | ||||
| City | STATE COLLEGE |
| Zip Code | 16803 |
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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.