DARTHVADER DEVON WILLIAMSON (NPI# 1972166114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972166114 |
| Entity Type | Individual |
| Full Name | DARTHVADER DEVON WILLIAMSON |
| Credential | RSA |
| Practice Address |
2986 Kate Bond Rd Bartlett TN 38133-4003 |
| Mailing Address |
13560 Highway 196 Eads TN 38028-3606 |
| Practice Telephone | 9018207468 |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2019-04-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
MAS0000000047 | TN | Technologists, Technicians & Other Technical Service Providers |
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2986 KATE BOND RD |
| City | BARTLETT |
| State | TN |
| Zip Code | 38133-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013919851 | William D Wilcox | Emergency Medicine | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2005-08-11 |
| 1699374488 | Crystal Adrienne Hayes | Surgery | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2020-10-22 |
| 1609475532 | Aimee Katharine Tutton | Surgery | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2020-10-21 |
| 1871192773 | Debra Shannon | Surgery | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2020-10-21 |
| 1518571736 | Methodist Healthcare Bartlett Hospital | General Acute Care Hospital | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2020-09-04 |
| 1679181556 | Emily L Poppelreiter | Nurse Anesthetist, Certified Registered | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2020-07-16 |
| 1356971931 | Candice Scurlock | Nurse Practitioner | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2020-01-22 |
| 1366006801 | Bartlett Hospitalist Pllc | Hospitalist | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2019-04-30 |
| 1265919005 | Kejac Ventures LLC | Internal Medicine | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2018-07-24 |
| 1477055077 | Taryn Graves | Physical Therapist | 2986 Kate Bond Rd, Bartlett, TN 38133-4003 | 2018-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069201 | Warren Hilliard | Family Medicine | 7625 Hwy64, 107, Memphis, TN 38133 | 2020-10-06 |
| 1487142048 | David Charles Riddle | Pharmacist | 8400 Hwy 64, Bartlett, TN 38133 | 2018-04-28 |
| 1366943177 | Calandra White Shannon | Physical Therapist | 8025 Highway 64, Suite 102, Memphis, TN 38133 | 2018-02-27 |
| 1285144527 | Annice R.h. Overall | Social Worker | 2561 Sunny Glade Cove, Memphis, TN 38133 | 2017-09-30 |
| 1275050098 | Bartlett Asc, LLC | Clinic/Center | 3045 Kate Bond Road, Bartlett, TN 38133 | 2017-08-23 |
| 1407385297 | Tennessee Psychiatric Services Pllc | Psychiatry & Neurology | 2965 N Germantown Rd Ste 116, Bartlett, TN 38133 | 2017-06-06 |
| 1598113656 | Sensory World Memphis | Durable Medical Equipment & Medical Supplies | 2965 N Germantown Rd Suite 107, Bartlett, TN 38133 | 2016-05-31 |
| 1659754471 | Grant Coleman Dasher | Dentist | 2705 Appling Road Suite 101, Memphis, TN 38133 | 2015-06-30 |
| 1134533243 | Caelyn Newport | Chiropractor | 7879 Crescent Hill Dr., Memphis, TN 38133 | 2014-06-17 |
| 1033536479 | Lunceford Family Health Center | Internal Medicine | 7865 Edcator's Ln Suite 300, Bartlett, TN 38133 | 2014-03-24 |
| Find all providers in zip 38133 | ||||
| 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 |
|---|---|---|---|---|
| 1306007166 | Miri L Atkinson | Specialist/Technologist, Other | 1581 Spaulding Rd, Bartlett, IL 60103-1221 | 2008-06-24 |
| 1013573641 | Melissa Jill Jenkins | Specialist/Technologist, Other | 2996 Kate Bond Rd, Bartlett, TN 38133-4030 | 2019-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568092872 | Juan Carlos Zuluaga Bedoya | Specialist/Technologist, Other | 6885 Club Ridge Cir Apt 87, Memphis, TN 38115-7327 | 2020-01-26 |
| 1255802062 | Richard Charles Will Jr. | Specialist/Technologist, Other | 129 Paradise Dr, Hendersonville, TN 37075-4236 | 2018-12-06 |
| 1902385198 | Denisia Bernadette Maldonado | Specialist/Technologist, Other | 108 Medical Center Blvd., Suite #100, Fayetteville, TN 37334 | 2018-08-09 |
| 1821508094 | Jonathan Burkett | Specialist/Technologist, Other | 1168 Cynthia Ln, Spring Hill, TN 37174-4519 | 2017-10-02 |
| 1104346493 | Joseph Gary Robinson | Specialist/Technologist, Other | 4506 Polaris Dr, Chapelhill, TN 37034-2461 | 2017-06-27 |
| 1912437336 | Karl Robbins | Specialist/Technologist, Other | 8266 Beech Hill Rd, Frankewing, TN 38459-5059 | 2017-06-18 |
| 1659810521 | Lasundra Caslin | Specialist/Technologist, Other | 1711 Ray Jo Cir, Chattanooga, TN 37421-3370 | 2017-02-13 |
| 1902352172 | Jay Patrick Grayson | Specialist/Technologist, Other | 114 E Mcguire St, Bell Buckle, TN 37020-6052 | 2016-08-28 |
| 1033590906 | Robert Michael Frank | Specialist/Technologist, Other | 105 Noble Ct, Murfreesboro, TN 37128-3754 | 2015-06-16 |
| 1366833949 | Amber Cunningham | Specialist/Technologist, Other | 1117 Clift Cave Rd, Soddy Daisy, TN 37379-5706 | 2015-02-18 |
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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.