TYLER WACK (NPI# 1396264701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396264701 |
| Entity Type | Individual |
| Full Name | TYLER WACK |
| Practice Address |
125 Wigmore Lane Lexington SC 29072 |
| Mailing Address |
125 Wigmore Ln Lexington SC 29072-7784 |
| Practice Telephone | (803) 457-3722 |
| Mailing Telephone | 8034573722 |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
125 WIGMORE LANE |
| City | LEXINGTON |
| State | SC |
| Zip Code | 29072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484821 | Grace Physicians Services | Clinic/Center | 1483 Old Cherokee Road, Lexington, SC 29072 | 2020-10-12 |
| 1750995007 | Trinity Health and Wellness | Clinic/Center | 1483 Old Cherokee Rd, Lexington, SC 29072 | 2020-09-03 |
| 1730727629 | Erika Watts | Occupational Therapist | 100 Tarrar Springs Road, Sped, Lexington, SC 29072 | 2019-12-11 |
| 1194380600 | Lexington County Health Services District, Inc. | Clinic/Center | 154 Saluda Pointe Ct, Lexington, SC 29072 | 2019-05-09 |
| 1962973768 | William R. Key | Counselor | Lexington Community Mental Health Center, 301 Palmetto Park Boulevard, Lexington, SC 29072 | 2018-12-06 |
| 1639651961 | Lindsey Terry | Social Worker | 108 Palmetto Pk. Boulveard, Suite D, Lexington, SC 29072 | 2018-09-04 |
| 1922594126 | Dental Professional of South Carolina, P.C. | Dentist | 2448 Augusta Hwy, Lexington, SC 29072 | 2018-07-11 |
| 1598251605 | Lynn Marceline Beckett-lowe | Nurse Practitioner | 124 Pink Camellia Lane, Lexington, SC 29072 | 2018-07-02 |
| 1083120620 | Diana Reiss | Counselor | 714 S Lake Drive, 120, Lexington, SC 29072 | 2017-12-19 |
| 1649781857 | Constance Jean Lynch | Occupational Therapist | 800 North Lake Boulevard, Lexington, SC 29072 | 2017-10-14 |
| Find all providers in zip 29072 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117265 | Andrew Lanham | Student in an Organized Health Care Education/Training Program | 138 York St, Lexington, KY 40508-1879 | 2020-09-03 |
| 1780209429 | Hayley Elizabeth Webber | Student in an Organized Health Care Education/Training Program | 2151 Meeting St Apt 4210, Lexington, KY 40509-4646 | 2020-06-09 |
| 1568081974 | Nicole Marie Hall | Student in an Organized Health Care Education/Training Program | 374 Preston Ave, Lexington, KY 40502-1532 | 2020-04-15 |
| 1720607633 | Abigail Clark | Student in an Organized Health Care Education/Training Program | 800 Rose St Ste C-246, Lexington, KY 40536-0293 | 2020-04-10 |
| 1225657471 | Gabriella M Velonias | Student in an Organized Health Care Education/Training Program | 2261 Massachusetts Ave, Lexington, MA 02421-6712 | 2020-04-08 |
| 1811526866 | Evan Brady Lynch | Student in an Organized Health Care Education/Training Program | 740 South Limestone St Suite K454, Lexington, KY 40536-0293 | 2020-04-02 |
| 1982232237 | Brian Patrick Kinealy | Student in an Organized Health Care Education/Training Program | Uk Medical Center 800 Rose Street Room C-236, Lexington, KY 40536-0001 | 2020-03-31 |
| 1134757651 | Leonard Nsoyori Yenwongfai | Student in an Organized Health Care Education/Training Program | 800 Rose St Rm Ms -117, Lexington, KY 40536-0293 | 2020-03-30 |
| 1427686054 | James Hallahan | Student in an Organized Health Care Education/Training Program | 800 Rose St Pavillion H, Lexington, KY 40536-0001 | 2020-03-30 |
| 1285262824 | Ivan Huynh | Student in an Organized Health Care Education/Training Program | 740 South Limestone A219, Lexington, KY 40536-0001 | 2020-03-30 |
| Find all providers in LEXINGTON | ||||
Please comment or provide details below to improve the information on TYLER WACK.
| 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.