KEVIN WILLIAM WILSON (NPI# 1174633085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174633085 |
Entity Type | Individual |
Full Name | KEVIN WILLIAM WILSON |
Credential | DO |
Practice Address |
5966 W Curtisian Ave Boise ID 83704 |
Mailing Address |
3340 E Goldstone Way Meridian ID 83642 |
Practice Telephone | 2083025400 |
Practice Fax Number | 2083025455 |
Mailing Telephone | 2083025400 |
Mailing Fax Number | 2083025455 |
Enumeration Date | 2006-08-30 |
Last Update Date | 2020-08-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | O-1071 | ID | Allopathic & Osteopathic Physicians |
N | 207R00000X | Internal Medicine | 2688 | AZ | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 110388 | 05 |
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 |
5966 W CURTISIAN AVE |
City | BOISE |
State | ID |
Zip Code | 83704 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730169178 | Laurie J Ashby | Family Medicine | 5966 W Curtisian Ave, Boise, ID 83604 | 2006-01-20 |
1376079004 | Jeremy Crowfoot | Pharmacist | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2017-05-01 |
1881129146 | Sara Jean Smith | Nurse Practitioner | 5966 W Curtisian Ave, Boise, ID 83704 | 2017-04-25 |
1447707120 | Sherri Siegel | Nurse Practitioner | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2016-09-09 |
1124498860 | Danielle Burke | Physician Assistant | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2015-10-06 |
1376938076 | Caitlin Kinahan | Internal Medicine | 5966 W Curtisian Ave, Boise, ID 83704 | 2015-03-31 |
1619234622 | Alexandra Nicole Meier | Internal Medicine | 5966 W Curtisian Ave, Boise, ID 83704-8801 | 2012-04-15 |
1962468025 | Charles E Boult | Internal Medicine | 5966 W Curtisian Ave, Boise, ID 83706 | 2006-04-26 |
1174598684 | Victor Bartling | Family Medicine | 5966 W Curtisian Ave, Boise, ID 83704 | 2006-02-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
Find all providers in zip 83704 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891256004 | Ryan Thompson | Internal Medicine | 400 W Fort St # 111r, Boise, ID 83702-4531 | 2019-03-29 |
1518311679 | Samantha Hersrud | Internal Medicine | 500 W Fort St 111r, Internal Medicine Residency, Boise, ID 83702 | 2016-04-14 |
1649634718 | Elizabeth Ann Schackmann | Internal Medicine | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2016-04-05 |
1134513088 | Alex Tanabe | Internal Medicine | 1000 E Park Blvd, Boise, ID 83712-7791 | 2015-03-27 |
1104169283 | Jacqueline Kelly | Internal Medicine | 500 West Fort St. #111, Boise Vamc, Boise, ID 83702 | 2013-03-27 |
1083980734 | Shanaz Sikder | Internal Medicine | 403 S 11th St Ste 100, Boise, ID 83702 | 2012-03-27 |
1679869473 | Allyson J Komori | Internal Medicine | 500 W Fort St # 111, Suite 202, Boise, ID 83702-4501 | 2011-06-21 |
1982929048 | Sarita Anisha Kishore | Internal Medicine | 1970 Toluka Way, Boise, ID 83712-8547 | 2010-04-01 |
1568796282 | Life Quest Center Inc | Internal Medicine | 3355 N Five Mile Rd, Ste 284, Boise, ID 83713-3925 | 2009-09-28 |
1164673968 | Jenifer L Barry | Internal Medicine | 1525 S Owyhee St, Boise, ID 83705-6014 | 2008-10-10 |
Find all providers in BOISE |
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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.