WALLACE S. WILDER MD (NPI# 1659431013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659431013 |
| Entity Type | Organization |
| Organization Name | WALLACE S. WILDER MD |
| Other Organization Name | SUNNY VIEW PEDIATRICS |
| Practice Address |
210 Sunnyview Ln Suite 103 Kalispell MT 59901-3135 |
| Practice Telephone | 4067528300 |
| Practice Fax Number | 4067523542 |
| Mailing Telephone | 4067528300 |
| Mailing Fax Number | 4067523542 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2011-08-15 |
| Authorized Official Name | MRS. TRUDY B. WAGGENER (OFFICE MANAGER) |
| Authorized Official Telephone | 4067528300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
3655 | MT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0066495 | 05 | |
| MT | BCBS - LYNN A. DYKSTRA MD | 95755 | 01 |
| MT | 0032344 | 05 | |
| MT | BCBS - WALLACE WILDER MD | 08110 | 01 |
| MT | 0437529 | 05 | |
| MT | BCBS - MICHAEL SCHWALLER | 92168 | 01 |
| MT | BCBS - VALERIE BEEBE | 371330 | 01 |
| Other Name | Type Code |
|---|---|
| Sunny View Pediatrics | Doing Business As Name - Organization |
| Street Address |
210 SUNNYVIEW LN SUITE 103 |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558316026 | Julie W Bates | Advanced Practice Midwife | 210 Sunnyview Ln, Suite 101, Kalispell, MT 59901-3135 | 2006-05-23 |
| 1326493727 | Erin Caitlin Lauer | Obstetrics & Gynecology | 210 Sunnyview Ln, Kalispell, MT 59901-3135 | 2016-05-04 |
| 1972982981 | Kalispell Regional Medical Center Inc | Obstetrics & Gynecology | 210 Sunnyview Ln, Suite 104, Kalispell, MT 59901-3135 | 2015-05-22 |
| 1053798710 | Kalispell Regional Medical Center Inc | Obstetrics & Gynecology | 210 Sunnyview Ln, Suite 103, Kalispell, MT 59901-3135 | 2015-05-01 |
| 1356675201 | Kimberley Marie Forthofer | Nurse Practitioner | 210 Sunnyview Ln, Suite 201, Kalispell, MT 59901-3135 | 2009-09-24 |
| 1740421023 | Jana J Sund | Advanced Practice Midwife | 210 Sunnyview Ln, Suite 101, Kalispell, MT 59901-3135 | 2009-03-16 |
| 1649300534 | Flathead Urology, Pllc | Clinic/Center | 210 Sunnyview Ln, Suite 106, Kalispell, MT 59901-3135 | 2007-03-07 |
| 1699874289 | James S. Bonnet M.d., P.C. | Surgery | 210 Sunnyview Ln, Suite 101, Kalispell, MT 59901-3135 | 2006-09-21 |
| 1922021518 | Wallace S Wilder | Pediatrics | 210 Sunnyview Ln, Suite 103, Kalispell, MT 59901-3135 | 2006-07-25 |
| 1033131891 | George W Mclean | Dermatology | 210 Sunnyview Ln, Ste 105, Kalispell, MT 59901 | 2006-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831571074 | North Valley Hospital | Clinic/Center | 26 Kintla Way, Kalispell, MT 59901-6871 | 2015-06-24 |
| 1306073465 | All Families Health Care, PC | Clinic/Center | 1060 N Meridian Rd, Kalispell, MT 59901-3542 | 2009-06-16 |
| 1013272459 | Kalispell Regional Medical Center Inc | Clinic/Center | 1273 Burns Way, Kalispell, MT 59901-3109 | 2012-07-11 |
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|---|---|---|---|---|
| 1134788185 | Pira Health LLC | Clinic/Center | 2825 Fort Missoula Rd Ste 201, Missoula, MT 59804-7403 | 2019-06-12 |
| 1629635115 | Country Home Medicine | Clinic/Center | 104 4th Street South, Plevna, MT 59344 | 2019-05-21 |
| 1386183622 | Theresa M. Kinney | Clinic/Center | 5820 N Montana Ave Trlr B1, Helena, MT 59602-6847 | 2017-02-20 |
| 1346691144 | Practice Health PC | Clinic/Center | 825 W Spruce St, Suite B, Missoula, MT 59802-3947 | 2016-06-23 |
| 1194183814 | Opulence Health, Pllc | Clinic/Center | 212 Lump Gulch Rd, Clancy, MT 59634-9770 | 2016-02-09 |
| 1386013423 | Golden Dragon Acupuncture | Clinic/Center | 1101 5th Ave N, Apt 10, Great Falls, MT 59401-4109 | 2015-09-18 |
| 1811371917 | Randy J. Lovell, Do, II, PC | Clinic/Center | 341 Hwy135, Saint Regis, MT 59866-0176 | 2015-07-17 |
| 1639552235 | East Lakeside Clinic | Clinic/Center | 7935 Mt Highway 35 Ste 201, Bigfork, MT 59911-5711 | 2015-07-01 |
| 1154664274 | River Valley Clinic, PC | Clinic/Center | 813 S Central Ave, Sidney, MT 59270-4940 | 2013-03-27 |
| 1942540356 | Micare, LLC | Clinic/Center | 2075 Overland Avenue, Billings, MT 59102 | 2013-02-21 |
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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.