DR. WESLEY JOSEPH DESSELLE (NPI# 1700887577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700887577 |
| Entity Type | Individual |
| Full Name | DR. WESLEY JOSEPH DESSELLE |
| Credential | MD |
| Practice Address |
1751 Veterans Dr Ste 125 Florence AL 35630-4932 |
| Mailing Address |
1751 Veterans Dr Ste 125 Florence AL 35630-4932 |
| Practice Telephone | 2567660150 |
| Practice Fax Number | 2567644638 |
| Mailing Telephone | 2563351643 |
| Mailing Fax Number | 2567644638 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2020-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 25005 | AL | Other Service Providers |
| N | 208600000X | Surgery | 00025005 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 114472 | 05 | |
| AL | MEDICAID LINK TO SURGICAL ASSOCIATES GROUP NUMBER | 529001490 | 01 |
| AL | 196318 | 05 | |
| AL | MEDICARE | 102I029080 | 01 |
| AL | BCBS LINK TO SURGICAL ASSOC | 511-13246 | 01 |
| AL | 1790879559 | 05 | |
| AL | BCBS ECM HEALTH GROUP, LLC | 511-89054 | 01 |
| FEDERAL ID SURGICAL ASSOC | 63-0962367 | 01 |
| Street Address |
1751 VETERANS DR STE 125 |
| City | FLORENCE |
| State | AL |
| Zip Code | 35630-4932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790326247 | Amy Southern Holt | Nurse Practitioner | 1751 Veterans Dr Ste 125, Florence, AL 35630-4932 | 2019-10-07 |
| 1093085268 | Robin Grimes Otte | Nurse Practitioner | 1751 Veterans Dr Ste 125, Florence, AL 35630-4932 | 2012-01-05 |
| 1407955248 | Michael Alan Boyd | Surgery | 1751 Veterans Dr Ste 125, Florence, AL 35630-4932 | 2006-09-21 |
| 1306804786 | Robert Louie Bailey Jr. | Surgery | 1751 Veterans Dr Ste 125, Florence, AL 35630-4932 | 2006-05-03 |
| 1356309652 | Tennessee Valley Surgery Group | Surgery | 1751 Veterans Dr Ste 125, Florence, AL 35630 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880531 | Rachel E Belue | Counselor | 409 N. Court Street, Florence, AL 35630 | 2020-01-15 |
| 1154857746 | Danish Henry | Internal Medicine | North Alabama Medical Center, 1701 Veterans Dr, Florence, AL 35630 | 2017-05-03 |
| 1396118261 | Three Oaks Pharmacy LLC | Pharmacy | 861 Cox Creek Parkway, Florence, AL 35630 | 2015-11-02 |
| 1235501891 | Wellness Walk-in Clinic, LLC | Nurse Practitioner | 2612 Hough Road, Florence, AL 35630 | 2015-10-22 |
| 1972995207 | Elyse Angel | Pharmacist | 109 East Dr Hicks Blvd, Florence, AL 35630 | 2015-02-24 |
| 1750772380 | Whitlee Laina Kelley | Case Manager/Care Coordinator | 112 Titan Drive, Florence, AL 35630 | 2015-02-18 |
| 1942612155 | Hillary Jean Delarosa | Internal Medicine | 162 Titan Drive, Florence, AL 35630 | 2014-05-22 |
| 1952723678 | Sharron M Boatwright | Nurse Practitioner | 1949 Florence Boulevard, Occupational Health Center LLC, Florence, AL 35630 | 2014-01-15 |
| 1194160523 | Caryn Barnett | Physical Therapist | 412 S. Court Street, Suite 403, Florence, AL 35630 | 2013-04-29 |
| 1396074662 | Heather White Bryant | Counselor | 118 East Mobile St, Suite 106, Florence, AL 35630 | 2009-12-16 |
| Find all providers in zip 35630 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578007837 | Max Keefe | Specialist | 901 W Palmetto St, Florence, SC 29501-4352 | 2016-12-06 |
| 1124486741 | Bianca Deris | Specialist | 1015 Prestwick Ct, Florence, OR 97439-9585 | 2016-02-10 |
| 1831517689 | Thomas M Staley | Specialist | 1622 Caddie Cir, Florence, KY 41042-7033 | 2014-03-30 |
| 1851739551 | Lee Richard Hayne | Specialist | 660 Sweeney Cr. Lp., Florence, MT 59833 | 2013-06-05 |
| 1043521164 | Orachun Sittisuntorn, Md, LLC | Specialist | 514 S Dargan St Ste D, Florence, SC 29506-2552 | 2010-06-23 |
| 1104085034 | Donald Stewart | Specialist | 230 Indian Springs Dr, Florence, AL 35634-2056 | 2008-06-05 |
| 1730358342 | Michelle Renee Angilletta | Specialist | 1525 12th St Ste 2a, Florence, OR 97439-9498 | 2008-02-27 |
| 1881884351 | Sequoia Shelly Warner | Specialist | 2970 Highway 101, Florence, OR 97439-9711 | 2007-07-30 |
| 1255537171 | Pediatric Therapy Specialists, Inc. | Specialist | 7536 Us Hwy 42, Suite 2, Florence, KY 41042 | 2007-06-26 |
| 1619183159 | Diane Kathleen Dressler | Specialist | 1925 W Creek Rd, Florence, VT 05744-9815 | 2007-05-14 |
| Find all providers in FLORENCE | ||||
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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.