MR. EUGENE PATRICK KISTLER (NPI# 1073618880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073618880 |
| Entity Type | Individual |
| Full Name | MR. EUGENE PATRICK KISTLER |
| Credential | PA-C |
| Practice Address |
4500 Stuart St Moncrief Army Community Hospital Columbia SC 29207-5700 |
| Practice Telephone | 8037512618 |
| Mailing Telephone | 8037512618 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
NCCPA 1020290 | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4500 STUART ST MONCRIEF ARMY COMMUNITY HOSPITAL |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29207-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505231 | Christopher Michael Enke | Occupational Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2020-10-09 |
| 1366071144 | Kaitlin Chrastek | Specialist/Technologist | 4500 Stuart St, Columbia, SC 29207-5700 | 2020-04-03 |
| 1316582455 | Melissa Angela Metivier | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2019-11-13 |
| 1952954695 | Jeriann Sandrik | Optometrist | 4500 Stuart St, Columbia, SC 29207 | 2019-07-22 |
| 1669946455 | Tonya Yvette Parks | Counselor | 4500 Stuart St, Columbia, SC 29207-5700 | 2019-01-15 |
| 1538653795 | Jennifer L Willard | Licensed Practical Nurse | 4500 Stuart St, Columbia, SC 29207-5700 | 2018-06-20 |
| 1114469475 | Carrie Elizabeth Green | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-11-17 |
| 1841640489 | Daniel Greathouse | Optometrist | 4500 Stuart St, 3rd Floor Clinic Wing, Columbia, SC 29207-5700 | 2016-06-14 |
| 1356796205 | Rajesh Devkota | Nurse Practitioner | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-04-28 |
| 1114385770 | Garry Dredge | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
| 1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
| 1730733007 | Forrest Wane Fullenkamp | Student in an Organized Health Care Education/Training Program | 5330 Moseby St, Columbia, SC 29207 | 2019-07-25 |
| 1306401625 | Kayla Anne Wolcott | Pharmacist | Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 | 2019-05-02 |
| 1588145098 | Renetta Denise Green | Counselor | Fort Jackson/acs 9810 Lee St, Columbia, SC 29207 | 2018-08-23 |
| 1154814028 | Amanda Zelnick | Dentist | Bldg 5330 Moseby St, Ft Jackson, NC 29207 | 2018-06-14 |
| 1790231777 | Brittaney Elizabeth Anne Lewelling | Specialist/Technologist | 5975 Chesnut Road, Columbia, SC 29207 | 2016-08-30 |
| 1376749838 | Moncrief Army Community Hospital | Clinic/Center | 5330 Mosby Street, Fort Jackson, SC 29207 | 2007-06-22 |
| 1902002462 | Moncrief Army Community Hospital | Clinic/Center | 1890 Washington Road, Fort Jackson, SC 29207 | 2007-06-22 |
| 1730279860 | Donna L Briquet | Pharmacist | 4500 Marion Street, Columbia, SC 29207 | 2006-10-12 |
| Find all providers in zip 29207 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392495 | Stephanie Meyer | Physician Assistant | 5 Medical Park Road Palmetto Health, Columbia, SC 29203 | 2017-12-18 |
| 1629434279 | Jennifer Templeton | Physician Assistant | 110 Highland Center Drive, Columbia, SC 29203 | 2016-01-12 |
| 1184023871 | Candace Parker Fleming | Physician Assistant | 109 W Legion Ave, Columbia, IL 62236-2341 | 2014-08-19 |
| 1194147470 | Frederick Parker | Physician Assistant | 9 Richland Medical Park Drive, Suite 450, Columbia, SC 29203 | 2014-01-06 |
| 1780999037 | Spectrum Pain Clinics, Inc | Physician Assistant | 230 East James Campbell Blvd, Suite 102, Columbia, TN 38401 | 2010-08-11 |
| 1770728834 | Joan Chandler Hornick | Physician Assistant | 2 Medical Park Rd Ste 404, Columbia, SC 29203-6875 | 2008-12-03 |
| 1164683926 | Kimberly Shirk | Physician Assistant | 612 Saint Andrews Rd Ste 2, Columbia, SC 29210-5120 | 2008-06-24 |
| 1295869485 | Karen Traynham | Physician Assistant | 303 N Keene St Ste 301, Columbia, MO 65201-7193 | 2007-03-16 |
| 1508926817 | Nina D Garcia | Physician Assistant | 8850 Columbia 100 Pkwy Ste 316, Columbia, MD 21045-2377 | 2006-12-11 |
| 1467526418 | Tamenia Bluford Bluford | Physician Assistant | 4 N Bay Xing, Columbia, SC 29229-7507 | 2006-11-20 |
| Find all providers in COLUMBIA | ||||
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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.