MR. KENNETH KIM WYNNE (NPI# 1558689745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558689745 |
| Entity Type | Individual |
| Full Name | MR. KENNETH KIM WYNNE |
| Credential | PA-C |
| Practice Address |
196 W Sproul Rd Suite 110 Springfield PA 19064-2045 |
| Practice Telephone | 6103288760 |
| Practice Fax Number | 6103288767 |
| Mailing Telephone | 6103288760 |
| Mailing Fax Number | 6103288767 |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2010-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
OA000744 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841363587 | Kenneth Arthur Wynne | Dentist | 1000 E Dimond Blvd, 205, Anchorage, AK 99515 | 2006-11-17 |
| Street Address |
196 W SPROUL RD SUITE 110 |
| City | SPRINGFIELD |
| State | PA |
| Zip Code | 19064-2045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669446159 | Domenic Pisano | Internal Medicine | 196 W Sproul Rd, Suite 106, Springfield, PA 19064-2045 | 2006-02-14 |
| 1629575204 | Kennneth Joseph Santello | Family Medicine | 196 W Sproul Rd, Springfield, PA 19064-2045 | 2018-04-10 |
| 1336645860 | Rocky Marsero | Physical Medicine & Rehabilitation | 196 W Sproul Rd, Springfield, PA 19064-2045 | 2018-04-03 |
| 1528413002 | Prospect Health Access Network, Inc. | Family Medicine | 196 W Sproul Rd, Suite 110, Springfield, PA 19064-2045 | 2016-05-03 |
| 1891182283 | Jeff Ellis | Specialist/Technologist | 196 W Sproul Rd, Springfield, PA 19064-2045 | 2015-04-23 |
| 1760772198 | Kathleen Destefano Glenn | Pediatrics | 196 W Sproul Rd, Healthplex Suite 205, Springfield, PA 19064-2045 | 2011-04-19 |
| 1417278789 | Kevin Duprey | Family Medicine | 196 W Sproul Rd, Suite 110, Springfield, PA 19064-2045 | 2010-06-21 |
| 1669682324 | Health Access Network | Obstetrics & Gynecology | 196 W Sproul Rd, Suite 209, Springfield, PA 19064-2045 | 2007-05-23 |
| 1538287644 | Health Access Network | Family Medicine | 196 W Sproul Rd, Suite 110, Springfield, PA 19064-2045 | 2007-03-27 |
| 1629109616 | Kathleen Milliken | Nurse Practitioner | 196 W Sproul Rd, Springfield, PA 19064-2045 | 2007-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023513058 | Prospect Crozer Home Health and Hospice, LLC | Hospice Care, Community Based | 200 W. Sroul Road, Springfield, PA 19064 | 2018-03-30 |
| 1912369539 | Olga Burt | Physical Therapy Assistant | 146 Rose Lane, Springfield, PA 19064 | 2016-03-23 |
| 1124407309 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1745 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1477932655 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1755 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1003295288 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1765 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1427483742 | Casseys Optical Inc | Durable Medical Equipment & Medical Supplies | 139 S State Road, Springfield, PA 19064 | 2013-09-05 |
| 1184982225 | Ultimate Hearing Solutions II, LLC | Audiologist-Hearing Aid Fitter | 471 Baltimore Pike, Springfield, PA 19064 | 2012-04-26 |
| 1295091684 | Theresa Nolan | Registered Nurse | 194 West Sprould Road, Suite 105, Springfield, PA 19064 | 2012-04-10 |
| 1649551367 | Pa Center for Hearing and Balance, LLC | Hearing Aid Equipment | 760 W Sproul Road, Suite 103, Springfield, PA 19064 | 2011-09-08 |
| 1376864694 | Cynthia Lacapra | Family Medicine | 965 Baltimore Pike Ste B2, Springfield, PA 19064 | 2010-06-22 |
| Find all providers in zip 19064 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871122168 | Alexandra Emmanuelle Rochman | Physician Assistant | 54 W Crystal Brook Dr, Springfield, MA 01118-1946 | 2020-04-07 |
| 1740740737 | Western New England University | Physician Assistant | 215 Wilbraham Road, Springfield, MA 01119 | 2019-03-25 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| 1770850216 | Lauren Jennifer Navas | Physician Assistant | 100 River St Ste 2, Springfield, VT 05156-2930 | 2011-11-29 |
| 1295885168 | Jacqueline Kernaghan | Physician Assistant | 723 Saxer Ave, Springfield, PA 19064-3503 | 2007-01-11 |
| 1295746733 | Gwen Wright | Physician Assistant | 194 W Sproul Rd, Suite 105, Springfield, PA 19064-2027 | 2006-08-10 |
| 1164490710 | Stacie L Pierce | Physician Assistant | 3721 W El Castile St, Springfield, MO 65807-5431 | 2006-03-09 |
| 1245206432 | Annette K Bates | Physician Assistant | 819 Worcester St Ste 3, Springfield, MA 01151-1056 | 2006-02-27 |
| 1518947159 | Louis Patrick Favata | Physician Assistant | 140 High St., Springfield, MA 01199 | 2006-01-19 |
| 1649257031 | Scott D Rubin | Physician Assistant | 3400 Main Street, Springfield, MA 01107-1113 | 2005-12-27 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 19064 |
Please comment or provide details below to improve the information on MR. KENNETH KIM WYNNE.
| 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.