TERRY L RESIDE


Address: 1604 Visa Dr, Normal, IL 61761-2195
Phone: 3098464716

TERRY L RESIDE (NPI# 1235468729) 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) 1235468729
Entity Type Individual
Full Name TERRY L RESIDE
Credential CST, SA-C
Practice Address 1604 Visa Dr
Normal
IL 61761-2195
Practice Telephone 3098464716
Practice Fax Number 3094541107
Mailing Telephone 3098464716
Mailing Fax Number 3094541107
Enumeration Date 2009-12-14
Last Update Date 2009-12-14
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 246ZC0007X Specialist/Technologist, Other
Specialization: Surgical Assistant
238000219 IL Technologists, Technicians & Other Technical Service Providers

Office Location

Street Address 1604 VISA DR
City NORMAL
State IL
Zip Code 61761-2195

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659490761 Definitive Neurodiagnostics LLC Specialist/Technologist, Other 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 2007-03-28
1487209664 Sam Daliri Dentist 1604 Visa Dr, Normal, IL 61761-2195 2019-08-05
1346783982 Everyone's Family Dental Normal LLC Dentist 1604 Visa Dr, Ste 3, Normal, IL 61761-2195 2016-11-30
1134678790 Michael Hansen Specialist/Technologist, Other 1604 Visa Dr, Ste 1, Normal, IL 61761 2016-09-23
1295281228 Brenna Catherine Maxine Knott Specialist/Technologist, Other 1604 Visa Dr, Normal, IL 61761-2195 2016-08-30
1750766499 Dhaval Patel Dentist 1604 Visa Dr, Normal, IL 61761-2195 2015-07-23
1467830869 Deborah Berryman Specialist/Technologist, Other 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 2015-05-18
1184002578 Susan Ribordy Specialist/Technologist, Other 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 2015-05-18
1447667027 Phyllis Wilkinson Licensed Practical Nurse 1604 Visa Dr, Ste 2, Normal, IL 61761 2014-07-16
1629484324 Brian Choi Dentist 1604 Visa Dr, Unit #3, Normal, IL 61761-2195 2014-07-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629681796 Brittany Nicole Mekley Nurse Practitioner 201 N. University, Normal, IL 61761 2020-08-28
1679108971 Krystal Halliday Occupational Therapist 1815 N Towanda Barnes Rd, Normal, IL 61761 2020-03-06
1265915474 Laine E Burek Nurse Practitioner 1765 Bradford Ln., Normal, IL 61761 2018-09-13
1801389986 Ashley Michelle James Specialist/Technologist 347 S. University St, Normal, IL 61761 2018-06-12
1447750708 Shelley R. Ruch Specialist/Technologist, Other 1604 Visa Drive, Ste 1, Normal, IL 61761 2018-02-13
1497275069 Mclean County Nursing Home Non-emergency Medical Transport (VAN) 901 N. Main St, Normal, IL 61761 2017-06-23
1235673666 Megan Threm Registered Nurse 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 2016-12-04
1437513553 Tiesha Smith Specialist 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 2016-04-06
1285031658 New Day Recovery Community/Behavioral Health 402 Summit, Normal, IL 61761 2014-12-01
1174927701 Alyssa Marie Bruck Occupational Therapist 700 N Walnut St, Normal, IL 61761 2014-10-10
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Taxonomy Information

Taxonomy Code 246ZC0007X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Specialist/Technologist, Other
Specialization Surgical Assistant

Taxonomy Definition

A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training.
Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770887887 Marlon Minor Specialist/Technologist, Other 112 Boeykens Pl Ste 2a, Normal, IL 61761-2152 2011-01-04
1417287228 Tonya Legrand Specialist/Technologist, Other 2875 E Raab Rd, Normal, IL 61761-9540 2009-12-30
1538714191 Douglas S Holt Specialist/Technologist, Other 1604 Visa Dr Ste 1, Normal, IL 61761-2195 2019-08-09
1639586217 Sylke Weaver Specialist/Technologist, Other 1604 Visa Dr., Ste. 2, Normal, IL 61761 2014-07-16
1902156995 Dawn Baker Specialist/Technologist, Other 1604 Visa Dr, Ste. 2, Normal, IL 61761-2195 2012-09-17
1962706275 Shawna Summers Specialist/Technologist, Other 1604 Visa Dr Ste 1, Normal, IL 61761-2195 2010-12-29
1588966840 Kimberly A Mancilla Specialist/Technologist, Other 1604 Visa Dr, Suite 1, Normal, IL 61761-2195 2010-11-18
1083855142 Debbie Bessent Specialist/Technologist, Other 1604 Visa Dr, Suite #1, Normal, IL 61761-2195 2009-03-18
1194962670 Stacey J Giese Specialist/Technologist, Other 1604 Visa Dr Ste 1, Normal, IL 61761-2195 2009-01-20
1912144494 Tasha Thomas Specialist/Technologist, Other 1604 Visa Dr Ste 1, Normal, IL 61761-2195 2009-01-20
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Competitor

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City NORMAL
Zip Code 61761

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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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