WILFREDO I VERGARA (NPI# 1366435398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366435398 |
| Entity Type | Individual |
| Full Name | WILFREDO I VERGARA |
| Credential | MD |
| Practice Address |
245 Governors Dr Se Huntsville AL 35801-2700 |
| Mailing Address |
Po Box 2705 Huntsville AL 35804-2705 |
| Practice Telephone | 2562657981 |
| Mailing Telephone | 2568016047 |
| Mailing Fax Number | 2568016218 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
ME140266 | FL | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
27740 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009914158 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5153 N 9th Ave, Pensacola, FL 325048785 | 8504167710 | 8504166729 |
| Street Address |
245 GOVERNORS DR SE |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912518861 | Tyler Joe Fadorsen | Nurse Practitioner | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2020-08-13 |
| 1184234676 | Brianna Michelle Moultrie | Registered Nurse | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2020-08-09 |
| 1518583996 | Laura Beth Rouse | Nurse Anesthetist, Certified Registered | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2020-06-22 |
| 1528687035 | Jamie Hunter | Registered Nurse | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2020-04-14 |
| 1366077562 | Santrice Pleasant | Pediatrics | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2020-03-08 |
| 1255964425 | Sarah Heimsness Davis | Nurse Practitioner | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2020-02-17 |
| 1750914065 | Jeanette Olivia Craven | Registered Nurse | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2020-02-14 |
| 1356989784 | Amy Hall | Nurse Practitioner | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2019-12-17 |
| 1578109781 | Lauren Anne Higginbotham | Registered Nurse | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2019-11-22 |
| 1205489986 | Jessica Stroud | Nurse Practitioner | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2019-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720437205 | Devasena Iyer | Pediatrics | 245 Governors Dr Se, Huntsville, AL 35801-2700 | 2016-06-06 |
| 1396884524 | Pediatric Intensivist | Pediatrics | 401 Lowell Dr Se, Suite 14, Huntsville, AL 35801-3748 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063702454 | Madhura Adiga Hallman | Pediatrics | 1600 7th Ave S Ste 102, Birmingham, AL 35233 | 2011-04-19 |
| 1174170963 | Adeline Phillips | Pediatrics | 1600 7th Ave S, Birmingham, AL 35233-1711 | 2019-08-26 |
| 1154989598 | Usa Health Physician Billing Services LLC | Pediatrics | 1700 Center St, Mobile, AL 36604-3301 | 2019-05-31 |
| 1407216583 | University of South Alabama | Pediatrics | 1700 Center St, Mobile, AL 36604-3301 | 2016-03-02 |
| 1265879084 | Emily C Dodenhoff | Pediatrics | 1600 7th Ave South, Cppi 102 Division of Pediatric Critical Care, Birmingham, AL 35233 | 2013-06-03 |
| 1295084291 | Kamal Prasad Sharma | Pediatrics | 1700 Center St, Mobile, AL 36604-3301 | 2012-09-05 |
| 1033340492 | Wail Ali | Pediatrics | 1700 Center St, Mobile, AL 36604-3301 | 2009-08-04 |
| 1245492453 | Cristina Elena Gavrilita | Pediatrics | 1700 Center St, Mobile, AL 36604-3301 | 2008-06-29 |
| 1174783708 | Chrystal Lashawn Rutledge | Pediatrics | 1600 7th Ave S, Cppi Suite 102, Birmingham, AL 35233-1711 | 2008-06-17 |
| 1770787848 | Santiago Borasino | Pediatrics | 1600 7th Ave S, Birmingham, AL 35233-1711 | 2007-06-13 |
| Find all providers with the same taxonomy | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
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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.