MR. DARREL SIDES (NPI# 1114079878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114079878 |
| Entity Type | Individual |
| Full Name | MR. DARREL SIDES |
| Credential | CSA |
| Practice Address |
6271 Martys Trail Independence KY 41051-0583 |
| Mailing Address |
Po Box 583 Independence KY 41051-0583 |
| Practice Telephone | 8598166684 |
| Practice Fax Number | 8593560682 |
| Mailing Telephone | 8598166684 |
| Mailing Fax Number | 8593560682 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
SA109 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | BC | 000000308821 | 01 |
| Street Address |
6271 MARTYS TRAIL |
| City | INDEPENDENCE |
| State | KY |
| Zip Code | 41051-0583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738741 | Tina Hacker | Counselor | Crossroads Treatment Centers, 1974 Walton Nicholson Rd, Independence, KY 41051 | 2020-10-26 |
| 1942844972 | Shelby Cuellar | Chiropractor | 2051 Centennial Boulevard, Independence, KY 41051 | 2019-11-02 |
| 1811246242 | Independence Chiropractic, Inc. | Chiropractor | 1922 Walton Nichoolson Road, Independence, KY 41051 | 2012-08-30 |
| 1356627269 | Nina Carmen Brock | Home Health | 593 Berlander Dr, Independence, KY 41051 | 2011-10-25 |
| 1508000951 | Independence Urgent Care LLC | Clinic/Center | 2025 Declaration Drive, Independence, KY 41051 | 2009-04-29 |
| 1710009436 | Ashley Joseph Moser | Dentist | 2047 Centennial Blvd, Independence, KY 41051 | 2007-04-04 |
| 1558497388 | Occupational Health Centers of The Southwest, P.a., P.s.c. | Clinic/Center | 10110 Toebben Drive, Enterprise V Park, Independence, KY 41051 | 2007-02-26 |
| 1982758736 | Janice Ann Struckhoff | Dentist | 1986 Walton Nicholson Pike, Independence, KY 41051 | 2007-01-22 |
| 1265509061 | Regency Manor LLC | Assisted Living Facility | 11725 Madison Pike, Independence, KY 41051 | 2006-11-29 |
| 1588629463 | John Franklin Allnutt | Family Medicine | 5290 Madison Pike, Ste 100, Independence, KY 41051 | 2006-04-20 |
| Find all providers in zip 41051 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023262490 | Lindsay N. Fox | Physician Assistant | 5001 Rockside Rd # In-10, Independence, OH 44131-2172 | 2008-11-11 |
| 1265971733 | Carl Wesley Fillingame | Physician Assistant | 19550 E 39th St S Ste 230, Independence, MO 64057-2309 | 2017-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427429620 | Hannah Johnson | Physician Assistant | 4359 New Shepherdsville Rd Unit 245, Bardstown, KY 40004-8004 | 2015-10-13 |
| 1558666941 | Lisa Elaine Knipp | Physician Assistant | 72 Little Current Trl, Corbin, KY 40701-8535 | 2011-01-17 |
| 1366675886 | Meadow Creek Surgical Plc | Physician Assistant | 1420 Millertown Rd, Rockholds, KY 40759-7640 | 2009-09-01 |
| 1801063698 | Lake Cumberland Surgical Consultants Psc | Physician Assistant | 350 Hospital Way Ste 270, Somerset, KY 42503-1875 | 2008-05-12 |
| 1235305905 | Michelle Denise Cole | Physician Assistant | 3240 Mount Moriah Ave, Owensboro, KY 42303-7805 | 2008-05-02 |
| 1629275011 | Beverly A. Hatcher | Physician Assistant | 1725 Ashley Cir Ste 211, Bowling Green, KY 42104-5820 | 2007-06-28 |
| 1639374465 | Neurosurgical Associates of Western Kentucky, Psc | Physician Assistant | 225 Medical Center Dr Ste 401, Paducah, KY 42003-7914 | 2007-06-20 |
| 1255463196 | Robert Louis Boden | Physician Assistant | 320 Skyview Dr, Paris, KY 40361-1039 | 2007-03-09 |
| 1043345358 | Professional Surgical Assistants, Inc. | Physician Assistant | 1945 Scottsville Rd Ste B2 Pmb 397, Bowling Green, KY 42104-5836 | 2007-02-23 |
| 1124161609 | Linda Mae Moran | Physician Assistant | 275 Wedgewood Place, Paducah, KY 42001 | 2007-02-15 |
| Find all providers with the same taxonomy | ||||
| City | INDEPENDENCE |
| Zip Code | 41051 |
Please comment or provide details below to improve the information on MR. DARREL SIDES.
| 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.