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).
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 |
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 |
Street Address |
1604 VISA DR |
City | NORMAL |
State | IL |
Zip Code | 61761-2195 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 61761 |
Taxonomy Code | 246ZC0007X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
Specialization | Surgical Assistant |
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. |
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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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.