WESTSIDE MEDICAL, LLC (NPI# 1750536587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750536587 |
| Entity Type | Organization |
| Organization Name | WESTSIDE MEDICAL, LLC |
| Practice Address |
5235 Hhr Ranch Rd Wilson WY 83014 |
| Mailing Address |
Po Box 1582 Wilson WY 83014-1582 |
| Practice Telephone | 3077335676 |
| Practice Fax Number | 3077391048 |
| Mailing Telephone | 3077335676 |
| Mailing Fax Number | 3077391048 |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |
| Authorized Official Name | SALLY L.H. LUKE (OWNER) |
| Authorized Official Telephone | 3077335676 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
169260139 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WESTSIDE MEDICAL, LLC | Fratzke Property Management, 963 Sw Simpson Ave Ste 220, Bend, OR 97702 |
| Street Address |
5235 HHR RANCH RD |
| City | WILSON |
| State | WY |
| Zip Code | 83014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225067606 | Rafael M Williams | Orthopaedic Surgery | 5235 Hhr Ranch Rd, Snake River Orthopedics, Wilson, WY 83014-5235 | 2006-06-30 |
| 1043697683 | University of Utah Adult Services | Internal Medicine | 5235 Hhr Ranch Rd, Wilson, WY 83014-9210 | 2015-05-04 |
| 1437439684 | Michael Menolascino Md | Internal Medicine | 5235 Hhr Ranch Rd, Wilson, WY 83014-1929 | 2011-08-19 |
| 1922399716 | Teresa Joanne Enright | Nurse Practitioner | 5235 Hhr Ranch Rd, Wilson, WY 83014-9210 | 2011-04-27 |
| 1578720389 | Snake River Orthopedics PC | Orthopaedic Surgery | 5235 Hhr Ranch Rd, Wilson, WY 83014 | 2008-05-20 |
| 1194914747 | Christine Hurley Turner | Internal Medicine | 5235 Hhr Ranch Rd, Wilson, WY 83014-9210 | 2007-10-19 |
| 1679676530 | Christian A Guier | Orthopaedic Surgery | 5235 Hhr Ranch Rd, Wilson, WY 83014-9210 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551633 | Keith Ryan Knudson | Physical Therapist | 1230 North Fall Creek Rd, Wilson, WY 83014 | 2020-09-03 |
| 1578121588 | Nina Clark Lex | Physical Therapist | 1230 N Fall Creek Rd, Wilson, WY 83014 | 2019-06-04 |
| 1659840403 | Hannah Lee Tripp | Dietitian, Registered | 1440 N West St., Wilson, WY 83014 | 2018-11-21 |
| 1902307952 | Joseph Anthony Sorge | Medical Genetics | 5320 Pine Meadow Road, Wilson, WY 83014 | 2018-02-26 |
| 1184174393 | Dean Woodmencey | Specialist | 4030 West Lake Creek Dr., Wilson, WY 83014 | 2016-10-12 |
| 1740657261 | Peter Moffatt | Counselor | 7905 South Fall Creek Road, Wilson, WY 83014 | 2015-09-01 |
| 1669722419 | Jeremy Silcox | Social Worker | 7905 Fall Creek Rd., Wilson, WY 83014 | 2012-09-19 |
| 1649533811 | Harriet Elizabeth Wardle | Social Worker | 3850 N Wilderness Dr, Wilson, WY 83014 | 2012-06-21 |
| 1205197043 | Laura Lea Perez | Psychologist | 3850 North Wilderness Dr., Wilson, WY 83014 | 2012-06-07 |
| 1306105689 | William Douglas Odell | Specialist | 5445 Cottonwood Canyon Road, Wilson, WY 83014 | 2012-05-08 |
| Find all providers in zip 83014 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205467586 | Erica Braswell Kearney | Nurse Practitioner | 3804 Columbia Ave Nw, Wilson, NC 27896-1622 | 2020-01-27 |
| 1700306297 | Kimberly Denton Almkuist | Nurse Practitioner | Wilson County Health Department, 1801 Glendale Dr. Sw, Wilson, NC 27893 | 2017-06-26 |
| 1225400716 | Chasity Hilliard Godwin | Nurse Practitioner | 1800 Herring Ave E, Wilson, NC 27893-6727 | 2015-10-23 |
| 1548599244 | William Neil Boykin | Nurse Practitioner | 3725 Nash St Nw, Wilson, NC 27896-1127 | 2009-12-09 |
| 1740312172 | Sally L Luke | Nurse Practitioner | 1230 Ida Lane, Wilson, WY 83014 | 2007-03-12 |
| 1245375302 | Carolyn Sue Howell | Nurse Practitioner | 1801 Glemdale Dr. Sw, Wilson, NC 27893-4401 | 2007-02-20 |
| 1801947783 | Eleanor Jane Guarini | Nurse Practitioner | 4514 Nash St N, Wilson, NC 27896-8711 | 2007-01-16 |
| 1487623005 | Janice Whiting Stump | Nurse Practitioner | 114 Brentwood Center Ln N, Wilson, NC 27896-1710 | 2006-03-16 |
| 1417588245 | Jacob Laney Hines | Nurse Practitioner | 303 Green St E, Wilson, NC 27893-4105 | 2020-01-30 |
| 1760045876 | Amanda Ellis Biermann | Nurse Practitioner | 1800 Herring Ave E, Wilson, NC 27893-6727 | 2019-04-16 |
| Find all providers in WILSON | ||||
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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.