Trevor G Wilde (NPI# 1538422019, PAC ID# 5597910836) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1538422019 |
| PAC ID by PECOS | 5597910836 |
| Professional Enrollment ID | I20140731000138 |
| Full Name | Trevor G Wilde |
| Organization Legal Name | UPPER VALLEY COMMUNITY HEALTH SERVICES, INC. |
| Address |
72 S 1st Rexburg ID 83440-1902 |
| Phone Number | 2083564900 |
| Gender | M |
| Medical School | A T STILL UN, ARIZONA SCHL OF DENT.Y & ORAL HLTH |
| Graduation Year | 2012 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4385725282 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130025 | MADISON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 72 S 1st, Rexburg, ID 83440-1902 | 2083564900 | UPPER VALLEY COMMUNITY HEALTH SERVICES, INC. |
| 20 N 3rd, Saint Anthony, ID 83445-1521 | 2086244100 | UPPER VALLEY COMMUNITY HEALTH SERVICES, INC. |
| Organization Legal Name | UPPER VALLEY COMMUNITY HEALTH SERVICES, INC. |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly S Davis | Psychologist, Clinical | Upper Valley Community Health Services, Inc. | 20 N 3rd, Saint Anthony, ID 83445-1521 |
| Whittney K Miller | Nurse Practitioner | Upper Valley Community Health Services, Inc. | 20 N 3rd, Saint Anthony, ID 83445-1521 |
| Alice Dawn Manwaring | Clinical Social Worker | Upper Valley Community Health Services, Inc. | 20 N 3rd, Saint Anthony, ID 83445-1521 |
| Bryant Hansen | Physician Assistant | Upper Valley Community Health Services, Inc. | 72 S 1st, Rexburg, ID 83440-1902 |
| Andrew L Brower | Physician Assistant | Upper Valley Community Health Services, Inc. | 20 N 3rd, Saint Anthony, ID 83445-1521 |
| Larry Miles Bradley | Clinical Social Worker | Upper Valley Community Health Services, Inc. | 20 N 3rd, Saint Anthony, ID 83445-1521 |
| Street Address |
72 S 1ST |
| City | REXBURG |
| State | ID |
| Zip | 83440-1902 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bryant Hansen | Physician Assistant | Upper Valley Community Health Services, Inc. | 72 S 1st, Rexburg, ID 83440-1902 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Craig Benjamin Ashby | Chiropractic | 16 S 1st, Rexburg, ID 83440-0303 | |
| Adriann J Wilcox | Nurse Practitioner | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Corey T Rammell | Family Medicine | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Joseph E Watson | Family Medicine | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Matheau G Eysser | Orthopedic Surgery | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Zachery M Brunson | Physician Assistant | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Charles J Zollinger | Family Medicine | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Rex Meredith | Physician Assistant | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Wade D Gordon | Clinical Social Worker | 310 N 2nd E, 112 South Fork Services, Rexburg, ID 83440-1606 | |
| Jody B Rawlings | Physical Therapy | 217 N 2nd, Rexburg, ID 83440-1621 | |
| Find all physicians in zip 83440 | |||
| City | REXBURG |
| Zip Code | 83440 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | REXBURG + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Trevor G Wilde.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.