DR. KIMBERLY EAKIN WEGENER (NPI# 1750344966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750344966 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY EAKIN WEGENER |
| Other Name | KIMBERLY EAKIN WEGENER |
| Credential | M.D. |
| Practice Address |
8288 S Broadway Ave Tyler TX 75703-5262 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9035931721 |
| Mailing Telephone | 9033246450 |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2014-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | K0459 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 88485Q | 01 |
| TX | RR/MEDICARE | 110211298 | 01 |
| TX | TRICARE | 752616977118 | 01 |
| TX | 040820502 | 05 | |
| TX | 0408205-01 | 05 |
| Street Address |
8288 S BROADWAY AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75703-5262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376549246 | John Jason Page | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2005-06-24 |
| 1427449529 | Sonja Faye Tiller | Nurse Practitioner | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2015-02-10 |
| 1669765350 | Mary Kathryn Eagleton | Pediatrics | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2011-05-27 |
| 1598993172 | Holly Akin Blanco | Pediatrics | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2009-06-23 |
| 1487893525 | Gale Jeannie Hobson | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2009-02-12 |
| 1063661148 | Andrea M Ellis | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2008-09-15 |
| 1235275314 | Kurt Nielsen | Emergency Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2007-01-29 |
| 1194743278 | Roy Brent Wadle | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2006-07-17 |
| 1003881608 | John W Scroggins | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2006-02-17 |
| 1952373987 | Catherine Zilinskas Giordano | Pediatrics | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2006-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386261329 | Metabolic Innovations Inc | Internal Medicine | 1420 Wsw Loop 323 Ste 3, Tyler, TX 75701-9355 | 2020-06-25 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1235487638 | Jaaca Medical | Internal Medicine | 9334 Chisholm Trl, Tyler, TX 75703-0407 | 2012-08-16 |
| 1306040092 | Byron Seth Decamp | Internal Medicine | 619 S Fleishel Ave Ste 203, Tyler, TX 75701-2067 | 2007-06-14 |
| 1225128259 | Peter Pitonak | Internal Medicine | 703 E Fleishel Ave, Ste 4000, Tyler, TX 75701-2015 | 2006-10-13 |
| 1699867366 | Sharlet Slough Do | Internal Medicine | 6115 New Copeland Rd Ste 240, Tyler, TX 75703 | 2006-09-29 |
| 1346349297 | Cynthia J Shepherd | Internal Medicine | 5414 S Broadway, Tyler, TX 75703-1335 | 2006-09-21 |
| 1245339183 | Kevin Glen May | Internal Medicine | 6723 Highlands Ct, Tyler, TX 75703-0584 | 2006-09-21 |
| 1144329087 | David W Ball | Internal Medicine | 5407 New Copeland Rd Ste 200, Tyler, TX 75703 | 2006-09-21 |
| 1134132749 | David James Sloan | Internal Medicine | 1100 E Lake Street, Suite 240, Tyler, TX 75701 | 2006-08-14 |
| Find all providers in TYLER | ||||
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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.