MR. JUSTIN WILDER (NPI# 1144731357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144731357 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN WILDER |
| Credential | RN |
| Practice Address |
201 Lavaca St Austin TX 78701-3960 |
| Practice Telephone | 7542340938 |
| Enumeration Date | 2017-10-14 |
| Last Update Date | 2017-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
930303 | TX | Nursing Service Providers |
| Street Address |
201 LAVACA ST |
| City | AUSTIN |
| State | TX |
| Zip Code | 78701-3960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501820 | Megan Elise Gittins | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School 1400 Ih-35, Cec 300, Austin, TX 78701 | 2020-06-04 |
| 1306467956 | Jason Russell Paxman | Internal Medicine | Dell Seton Medical Center 1500 Red River, Austin, TX 78701 | 2020-05-05 |
| 1992326078 | Sarah N Ibanez Shaw | Emergency Medicine | Ut Austin Dell Medical School Em Residency Program, 1400 N. I-35, Suite 2.230, Austin, TX 78701 | 2020-04-30 |
| 1215558689 | Margaret Marie Coates | Student in an Organized Health Care Education/Training Program | 1400 N Interstate Highway 35, Cec 2.404, Austin, TX 78701 | 2020-04-27 |
| 1740817956 | Woody Starcloud Green | Emergency Medicine | Dell Emergency Medicine Residency Program, 1400 N. Interstate Hwy 35, Suite 2.230, Austin, TX 78701 | 2020-03-26 |
| 1235771403 | Central Ortho Assists Pllc | Physician Assistant | 501 Congress, Suite 150, Austin, TX 78701 | 2019-10-09 |
| 1114575792 | Shyneice Lasha Gaddis | Behavior Technician | 100 Congress Ave Suite 2000, Austin, TX 78701 | 2019-08-28 |
| 1245887355 | Jonathan Thomas Mason | Family Medicine | 1400 N-ih 35, Dell Seton Medical Center, Ste C2.410, Austin, TX 78701 | 2019-08-22 |
| 1538726195 | Zahra Virginia Cain-akbar | Student in an Organized Health Care Education/Training Program | Ut Dell Medical, 1500 Red River St, Austin, TX 78701 | 2019-05-20 |
| 1457918021 | Sara Lugonjic | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School Neurology Program, 1400 Ih- 35, Cec 300, Austin, TX 78701 | 2019-05-20 |
| Find all providers in zip 78701 | ||||
| Taxonomy Code | 163WA0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326669532 | Michelle White | Registered Nurse | 357 Dove Creek Rd, Argyle, TX 76226-6360 | 2020-04-28 |
| 1043651367 | Lakisha Henderson | Registered Nurse | 2619 S. Lancaster Rd, Dallas, TX 75216 | 2013-07-15 |
| 1528373362 | Shelly Guillory | Registered Nurse | 1905 Elder Hill Rd, Driftwood, TX 78619-2102 | 2010-08-17 |
| 1043441074 | Marylyn Renee Harris | Registered Nurse | 6706 Old Oaks Blvd, Pearland, TX 77584-7140 | 2009-08-08 |
| 1366093544 | Stages of Recovery, Inc | Registered Nurse | 4413 71st St Ste G101, Lubbock, TX 79424-2319 | 2019-09-27 |
| 1619526902 | Us Multispecialty Group | Registered Nurse | 14008 Shadowglen Blvd, Manor, TX 78653-3396 | 2019-09-09 |
| 1902453327 | Emily Lauren Godsey | Registered Nurse | 1510 S Vine Ave, Tyler, TX 75701-2826 | 2019-08-20 |
| 1497310858 | Tanis May Rutherford | Registered Nurse | 13207 Wright Rd, Buda, TX 78610-5000 | 2019-05-01 |
| 1437437464 | Courtney Carole Fuller | Registered Nurse | 8104 County Road 6500, Lubbock, TX 79416-9557 | 2011-07-25 |
| 1154563419 | Jo Ann Goodie | Registered Nurse | 4112 Austin St, Houston, TX 77004-4813 | 2009-04-01 |
| Find all providers with the same taxonomy | ||||
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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.