BRENT WILDBERGER (NPI# 1740654631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740654631 |
| Entity Type | Individual |
| Full Name | BRENT WILDBERGER |
| Credential | PA-C |
| Practice Address |
1855 Spring Hill Ave Mobile AL 36607-2301 |
| Practice Telephone | 2514713544 |
| Mailing Telephone | 2514713544 |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2019-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1855 SPRING HILL AVE |
| City | MOBILE |
| State | AL |
| Zip Code | 36607-2301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558396093 | Karen Renae Jordan | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2006-07-12 |
| 1881227148 | Lauren M. Coaker | Nurse Practitioner | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2020-02-14 |
| 1841848553 | Imc-cardio-thoracic and Vascular Surgical Associates LLC | Surgery | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2019-08-27 |
| 1750869913 | Karli D Todd | Nurse Practitioner | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2018-07-31 |
| 1003354713 | Lauren Marie Mcminn | Nurse Practitioner | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2017-02-02 |
| 1669918538 | Tawny W Lewis | Nurse Practitioner | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2017-01-16 |
| 1659723856 | Martin Wesley Carter | Nurse Practitioner | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2016-07-12 |
| 1942679980 | Foster Goff IIi | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2015-09-21 |
| 1508269283 | Cassie Jones | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2014-10-08 |
| 1992110043 | Nicole Gollotte | Nurse Practitioner | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2014-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821404559 | Cindy Strahan | Occupational Therapy Assistant | 2900 Sping Hill Ave, Mobile, AL 36607 | 2014-07-02 |
| 1043649072 | Rebecca Clara Eskridge | Speech-Language Pathologist | 200 C East Portier Ct., Mobile, AL 36607 | 2013-11-12 |
| 1497016794 | Gregory Mark Quatrino | Surgery | 3 Mobile Infirmary Cir Ste 212, Mobile, AL 36607 | 2012-06-03 |
| 1457682197 | Joseph Michael Mckean | Dentist | 3050 Dauphin Square Connector, Mobile, AL 36607 | 2010-01-20 |
| 1679711956 | Sheldon Scott Bradley | Nurse Practitioner | 1 Infirmary Circle, Mobile Infirmary Er, Mobile, AL 36607 | 2009-01-26 |
| 1508058132 | Wanda K Miller | Occupational Therapist | 1903 Springhill Ave, Mobile, AL 36607 | 2007-08-17 |
| 1811035322 | George N Lukes | Dentist | 2653a Old Shell Road, Mobile, AL 36607 | 2007-02-05 |
| 1487702999 | Carl Maltese | Specialist | 1901 Springhill Ave, Mobile, AL 36607 | 2007-01-08 |
| 1790871242 | Cheryl Lambert Thames | Physical Therapist | 2006 Airport Blvd., Mobile, AL 36607 | 2006-10-04 |
| 1760576227 | Jane Bagwell Hale | Physical Therapist | 3202 Old Shell Road, Mobile, AL 36607 | 2006-10-02 |
| Find all providers in zip 36607 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437308665 | Melanie D. Busby | Physician Assistant | 3610 Springhill Memorial Dr. N., Mobile, AL 36608-1162 | 2008-09-11 |
| 1558396093 | Karen Renae Jordan | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2006-07-12 |
| 1346756160 | Nicholas K Bolling | Physician Assistant | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2017-12-15 |
| 1104345263 | Nathanael Christopher Stuck | Physician Assistant | 1601 Center St Ste 2s, Mobile, AL 36604-1541 | 2017-09-10 |
| 1942749965 | Judith Blake | Physician Assistant | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2017-02-23 |
| 1508269283 | Cassie Jones | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2014-10-08 |
| 1972931533 | Shawn Clark, M.d., P.C. | Physician Assistant | 6701 Airport Blvd, #c138, Mobile, AL 36608-6705 | 2013-10-17 |
| 1841524212 | Claire Hinton Naylor | Physician Assistant | 6144 Airport Blvd, Mobile, AL 36608 | 2009-10-01 |
| 1396994521 | Susan Angerholzer Overton | Physician Assistant | 1901 Springhill Ave, Mobile, AL 36607-2303 | 2008-09-11 |
| 1649328097 | Christine Paragone | Physician Assistant | 1901 Springhill Ave, Mobile, AL 36607-2303 | 2007-01-08 |
| Find all providers in MOBILE | ||||
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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.