MR. TIMOTHY L. WEIDE (NPI# 1861600017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861600017 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY L. WEIDE |
| Credential | P.A. |
| Practice Address |
1121 N College Park St Suite # 400 Derby KS 67037-3665 |
| Mailing Address |
22120 Sw Williams Rd Douglass KS 67039-8539 |
| Practice Telephone | 3167883376 |
| Practice Fax Number | 3167883378 |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2008-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1500761 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1121 N COLLEGE PARK ST SUITE # 400 |
| City | DERBY |
| State | KS |
| Zip Code | 67037-3665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346401973 | Lindsey Ann Moss | Social Worker | 1121 N College Park St, Suite 200, Derby, KS 67037-3665 | 2008-06-17 |
| 1871771998 | Derby Derm | Physician Assistant | 1121 N College Park St, Suite # 400, Derby, KS 67037-3665 | 2008-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114409182 | Lori Renee Young | Counselor | 1144 N. Buckner, Derby, KS 67037 | 2018-09-05 |
| 1295227585 | James Todd Hawkins | Social Worker | 918 E Wedgewood Dr., Derby, KS 67037 | 2018-06-01 |
| 1518454842 | Rock Regional Hospital, LLC | General Acute Care Hospital | 3251 Rock Road, Derby, KS 67037 | 2018-04-23 |
| 1093161325 | Inspired Care LLC | In Home Supportive Care | 1400 E Warren Ave, Derby, KS 67037 | 2016-05-05 |
| 1083095970 | Emily O'dell | Family Medicine | 1640 E Tall Tree Rd, Derby, KS 67037 | 2015-06-16 |
| 1700264017 | Grant Snider Dds, LLC | Dentist | 2701 North Rock Road, Suite 600, Derby, KS 67037 | 2015-05-07 |
| 1629472691 | Anaidy Claudio | Social Worker | 265 W Village Lake Dr, Derby, KS 67037 | 2014-10-20 |
| 1396094470 | Derby Assisted Living, LLC | Assisted Living Facility | 719 N. Klein Circle, Derby, KS 67037 | 2012-09-05 |
| 1700104635 | Cynthia D Holcomb | Social Worker | 1721 E. Osage, Suite 300, Derby, KS 67037 | 2010-05-17 |
| 1295066215 | Traci Lynn Borland | Occupational Therapist | 731 Klein Circle, Derby, KS 67037 | 2010-01-15 |
| Find all providers in zip 67037 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770025132 | Cayla Cirsten Daniele | Physician Assistant | 300 Seymour Ave Suite 102, Derby, CT 06418-1343 | 2016-11-16 |
| 1356704092 | Rock Road Emergency Physicians LLC | Physician Assistant | 63rd St S. Rock Road, Derby, KS 67227 | 2016-03-31 |
| 1649665936 | Jacqueline Braunworth | Physician Assistant | 68 Division St, Derby, CT 06418-1447 | 2015-04-02 |
| 1750464160 | Betsy L Strack | Physician Assistant | 6763 Erie Rd, Derby, NY 14047-9670 | 2006-10-23 |
| 1619933389 | Leon M Garcia | Physician Assistant | 130 Derby Ave, Derby, CT 06418-2010 | 2006-04-21 |
| 1679562664 | Debra Sue Longbine | Physician Assistant | 6970 Erie Rd, Derby, NY 14047-9591 | 2005-10-21 |
| 1093200644 | Jana L Scripp | Physician Assistant | 1640 E Tall Tree Rd, Derby, KS 67037 | 2018-06-26 |
| 1194217570 | Brianna Marie Weber | Physician Assistant | 130 Division St, Derby, CT 06418-1326 | 2018-06-01 |
| 1205355385 | Codie Marie Armstead | Physician Assistant | 1824 E James St, Derby, KS 67037 | 2017-09-11 |
| 1710418017 | Amanda Nicole Rea | Physician Assistant | 130 Division St, Derby, CT 06418-1326 | 2017-03-27 |
| Find all providers in DERBY | ||||
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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.