JEFFREY C WILT (NPI# 1366493488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366493488 |
| Entity Type | Individual |
| Full Name | JEFFREY C WILT |
| Credential | CRNA |
| Practice Address |
809 82nd Pkwy Myrtle Beach SC 29572-4607 |
| Mailing Address |
Po Box 1792 Columbia SC 29202-1792 |
| Practice Telephone | 8436921062 |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2008-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | R76080 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | AN1307 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720151004 | Jeffrey Allen Wilt | Family Medicine | 300 W Conan St, Ely, MN 55731-1145 | 2006-11-16 |
| 1033226097 | Jeffrey L Wilt | Internal Medicine | 1000 Oakland Dr, Kalamazoo, MI 49008-1282 | 2006-08-24 |
| 1659486165 | Jeffrey Allen Wilt | Internal Medicine | 6500 W Newberry Rd, Gainesville, FL 32605-4309 | 2006-08-21 |
| Street Address |
809 82ND PKWY |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679577035 | Thomas J Martel | Emergency Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2005-06-13 |
| 1104455211 | Chad Byrd | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-04-02 |
| 1831727122 | Michael Ladd | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-31 |
| 1932737335 | Aditya Ragunathan | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-31 |
| 1710515242 | Elise Erin Steinberger | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-30 |
| 1962030866 | Mitsy Jannet Moreno | Internal Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-28 |
| 1659908648 | Emma Kaitlyn Rousakis | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-27 |
| 1992333819 | Paul Harwood Hargrave | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-27 |
| 1134756109 | Oyindamola Awe | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-26 |
| 1003443292 | Benjamin Tyler Mckinney | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2020-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508221037 | Polaya Anesthesia LLC | Nurse Anesthetist, Certified Registered | 201 74th Ave N, Myrtle Beach, SC 29572-3832 | 2015-12-29 |
| 1003209412 | Travis Mills | Nurse Anesthetist, Certified Registered | 2432 Hunters Trl, Myrtle Beach, SC 29588-8444 | 2015-03-09 |
| 1912208489 | Christian Jefferies | Nurse Anesthetist, Certified Registered | 945 82nd Pkwy Ste 3a, Myrtle Beach, SC 29572-4612 | 2010-11-15 |
| 1275771750 | Nancy Anne Ciancione | Nurse Anesthetist, Certified Registered | 1474 Highland Cir, Myrtle Beach, SC 29575-5856 | 2009-01-22 |
| 1811559784 | Mbsc Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 827 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2019-07-01 |
| 1902314123 | Derek Christian May | Nurse Anesthetist, Certified Registered | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2018-01-22 |
| 1093242448 | Irina Walker | Nurse Anesthetist, Certified Registered | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2017-05-16 |
| 1366997140 | Jeanine Louise Christian-latouche | Nurse Anesthetist, Certified Registered | 7900 N Kings Hwy, Myrtle Beach, SC 29572-3055 | 2016-08-22 |
| 1043764814 | Lookaway Anesthesia LLC | Nurse Anesthetist, Certified Registered | 101 Surgeons Dr, Myrtle Beach, SC 29579-5198 | 2016-08-10 |
| 1457717977 | Christine Streisand | Nurse Anesthetist, Certified Registered | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2016-01-13 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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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.