TYLER WAGSTAFF


Address: 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167
Phone: 4062578992

TYLER WAGSTAFF (NPI# 1205266053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205266053
Entity Type Individual
Full Name TYLER WAGSTAFF
Practice Address 350 Heritage Way Ste 2100
Kalispell
MT 59901-3167
Practice Telephone 4062578992
Practice Fax Number 4062578996
Mailing Telephone 4062578992
Mailing Fax Number 4062578996
Enumeration Date 2013-11-14
Last Update Date 2020-06-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
PA1227 ID Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 350 HERITAGE WAY STE 2100
City KALISPELL
State MT
Zip Code 59901-3167

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922089705 Shelley Dawn Dugan Physician Assistant 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2005-11-09
1922633205 Sierra Langstaff Pharmacist 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2020-03-07
1104386374 Desiree Nicole Caro Nurse Practitioner 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2019-03-22
1558837708 Brady James Conner Pharmacist 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2018-10-15
1932680642 Kalispell Regional Medical Center, Inc. Clinic/Center 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2018-08-22
1609377803 Aimee Zupicich Nurse Practitioner 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2018-02-22
1699292615 Kira Kitchens Nurse Practitioner 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2017-08-30
1609326016 Paula Joann Brooks Nurse Practitioner 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 2016-10-10
1447627039 Jocelyn Oblizajek Nurse Practitioner 350 Heritage Way Ste 2100, Kalispell, MT 59901 2015-08-31
1659767721 Kalispell Regional Medical Center Inc Internal Medicine 350 Heritage Way Ste 2100, Kalispell, MT 59901 2015-04-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982226650 Mountain Physical Therapy and Fitness Center LLC Physical Medicine & Rehabilitation 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 2020-05-15
1164058350 Jessica Leeann Abell Physical Therapist 1825 Highway 93 S. Suite C, Kalispell, MT 59901 2020-03-19
1588216535 Diversified Therapeutic Services, Pllc Clinic/Center 30 E Washinton St, Suite A, Kalispell, MT 59901 2019-07-10
1467986216 Jill Shaver Counselor 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 2017-04-19
1003270810 Angela Otto Counselor 17 2nd St E Ste 204, Kalispell, MT 59901 2016-04-07
1548626989 Pamela Greskowiak Counselor 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 2016-01-14
1063894921 Joel Booth Dentist 690 N Meridian Rd Ste 106, Kalispell, MT 59901 2015-06-26
1982085841 Heather Reddig Specialist 751 Snowberry Trail, Kalispell, MT 59901 2015-06-16
1497147193 Patricia Greene Hall Psychologist 1035 1st Ave W Fl 3, Kalispell, MT 59901 2015-03-04
1720478886 Lori Mariani Social Worker 1605 Danielson Road, Kalispell, MT 59901 2015-01-28
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245341874 Tracy Edward Rogers Physician Assistant 202 Conway Dr Ste 200, Kalispell, MT 59901-3153 2006-08-31
1487644597 Timothy J Devries Physician Assistant 111 Sunnyview Ln, Kalispell, MT 59901-3164 2005-10-28
1427288836 Amy Lynn Tangedahl Physician Assistant 200 Commons Way Ste B, Kalispell, MT 59901-1915 2009-07-20
1437243763 Brianne Peltz Physician Assistant 202 Conway Dr Ste 200, Kalispell, MT 59901-3153 2006-10-03
1710084751 Samantha J Short Physician Assistant 350 Heritage Way, Suite 2100, Kalispell, MT 59901-3158 2006-09-20
1790896470 Gregory Urs Danielson Physician Assistant 111 Sunnyview Ln, Kalispell, MT 59901-3164 2006-08-31
1053422626 Steven Craig Trimble Physician Assistant 111 Sunnyview Ln, Kalispell, MT 59901-3164 2006-08-31
1386752186 Kristy Ehrmantraut Physician Assistant 60 Four Mile Dr Ste 10, Kalispell, MT 59901-2663 2006-08-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1598965097 Travis Lee Harris Physician Assistant 500 W. Broadway, Suite 320, St. Patrick Hospital, Missoula, MT 59802-4008 2007-07-23
1457576407 Rosalee Shorter Physician Assistant 341 Montana Hwy 135, Saint Regis, MT 59866-0176 2007-04-16
1881604668 Harley G Morrell Physician Assistant 2877 Overland Ave Ste C, Billings, MT 59102-7465 2006-08-08
1447802178 Reid Merrill Gage Physician Assistant 801 N 29th St, Billings, MT 59101-0905 2019-07-12
1083192025 Tyson Vanderby Physician Assistant 2675 Central Ave, Billings, MT 59102-6686 2018-08-01
1205384690 Christine Moen Physician Assistant 2900 12th Ave N, Suite 355w, Billings, MT 59101-7506 2016-09-14
1174973564 Jacob Wheeler Physician Assistant 925 Highland Blvd Ste 1100, Bozeman, MT 59715-6900 2016-06-15
1427414440 Kara Haskell Physician Assistant 1450 Ellis St, #201, Bozeman, MT 59715 2016-01-06
1437541471 Stephen Andrew Shepro Physician Assistant 2740 South Ave W Ste 101, Missoula, MT 59804-5137 2015-02-27
1346642667 Jennifer Vollmer Physician Assistant 1450 Ellis St Ste 201, Bozeman, MT 59715-8813 2014-09-17
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Competitor

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City KALISPELL
Zip Code 59901

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Dataset Information

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.

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