KYLE WERTZBERGER (NPI# 1952731200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952731200 |
Entity Type | Individual |
Full Name | KYLE WERTZBERGER |
Credential | PA-C |
Practice Address |
8803 S 101st East Ave Ste 100 Tulsa OK 74133-7546 |
Mailing Address |
1145 S Utica Ave Ste 110 Tulsa OK 74104-4013 |
Practice Telephone | 9185790220 |
Practice Fax Number | 9185792309 |
Mailing Telephone | 9185793825 |
Mailing Fax Number | 9185791262 |
Enumeration Date | 2013-11-24 |
Last Update Date | 2019-11-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | 2326 | OK | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2326 | OK | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
8803 S 101ST EAST AVE STE 100 |
City | TULSA |
State | OK |
Zip Code | 74133-7546 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982697553 | John F Line | Physician Assistant | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133-7546 | 2005-08-29 |
1013452499 | Susan Mitchell | Nurse Practitioner | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133 | 2016-12-21 |
1003268871 | Ashley Hilliker | Physician Assistant | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133-7546 | 2016-07-06 |
1295139319 | Amanda Beth Robison | Nurse Practitioner | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133 | 2014-10-17 |
1083017685 | Kristen Elise Giordano | Physician Assistant | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133-7546 | 2014-09-27 |
1003175258 | Elwood Fray Williams IIi | Anesthesiology | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133-7546 | 2012-05-09 |
1972808327 | Gannon Frederick Gill | Physician Assistant | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133-7546 | 2011-01-17 |
1427192434 | Yinyin Josephine Lauren Devoe | Family Medicine | 8803 S 101st East Ave Ste 100, Tulsa, OK 74133-7546 | 2007-02-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932725058 | Economy Pharmacy | Pharmacy | 10120 E 91st, Tulsa, OK 74133 | 2020-06-24 |
1710539424 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 9310 East 91st Street, Tulsa, OK 74133 | 2019-07-12 |
1003382060 | Carefirst Pharmacy Tulsa, Inc. | Pharmacy | 6214 S. Sheridan Rd, Tulsa, OK 74133 | 2018-10-17 |
1003397332 | Adekemi Taiwo | Nurse Practitioner | Hillcrest South Medical Plaza, 8803 S. 101 St E. Ave. Suite 350, Tulsa, OK 74133 | 2018-08-24 |
1346732013 | Lauren Nichols | Dentist | 7707 E 111th St Ste 105, Tulsa, OK 74133 | 2018-05-30 |
1699264259 | Courtney N Johnson, Pllc | Dentist | 7901 S Sheridan Rd Unit A, Tulsa, OK 74133 | 2018-05-08 |
1417464199 | Tulsa Medical and Orthopedic Center PC | Family Medicine | 8165 S Mingo Rd Ste 200, Tulsa, OK 74133 | 2018-01-04 |
1013421023 | Susan C. Willard, Do, Pllc | Family Medicine | 6532 E. 71st Street, Suite 150, Tulsa, OK 74133 | 2017-11-29 |
1851800825 | Seyva LLC | Clinic/Center | 8522 S 70th E Ave, Tulsa, OK 74133 | 2017-09-21 |
1477072031 | Amanda Dawn Long | Registered Nurse | 10507 E 91st St Ste 310, Tulsa, OK 74133 | 2017-09-14 |
Find all providers in zip 74133 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
1790155562 | Caldwell Medical Group of North Tulsa LLC | Physician Assistant | 8014 S 101st East Ave, Tulsa, OK 74133-4579 | 2015-10-05 |
1609298330 | Marci Love Deck | Physician Assistant | 2000 S Wheeling Ave Ste 1000, Tulsa, OK 74104-5648 | 2014-01-15 |
1619216272 | Nicole Lisette Mancinelli | Physician Assistant | 2424 E. 21st Street, Suite 320, Tulsa, OK 74114 | 2013-02-01 |
1184959389 | Erin Nicole Jones | Physician Assistant | 11212 E 48th St., Oklahoma Oncology, Tulsa, OK 74146-5806 | 2009-10-06 |
1194901793 | Annamae Kay | Physician Assistant | 1919 South Wheeling Ave, Ste 304, Tulsa, OK 74104 | 2008-01-14 |
1265632129 | Oklahoma Occupational Health Center | Physician Assistant | 5640 S Memorial Dr, Tulsa, OK 74145-9001 | 2007-07-19 |
1962535831 | Njanja Margaret Ruenji | Physician Assistant | Morton Comprehensive Health Services, 1334 N. Lasing Ave, Tulsa, OK 74106-5907 | 2007-03-13 |
1740355460 | Jeri Clark Goen | Physician Assistant | 3807 S Peoria Ave, Suite G and H, Tulsa, OK 74105-3145 | 2006-11-21 |
1790879237 | Steven Paul Henry | Physician Assistant | 10506 South Memorial Drive, Tulsa, OK 74133 | 2006-10-02 |
Find all providers in TULSA |
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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.