Keith Allen Wichinski, MSN, PMC,FNP-C, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

612139 Issued in TX

Practice address

311 W Laurel
San Antonio, TX 78212-4334

Phone

(844) 457-8525

Fax

(844) 457-8525

NPI assigned

Jul 24, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• River City Nurse Management LLC

  • Nurse Practitioner
  • San Antonio, TX
  • NPI 1679665244
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306046644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W LAUREL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124334",
            "telephone_number": "844-457-8525",
            "fax_number": "844-457-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W LAUREL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124334",
            "telephone_number": "844-457-8525",
            "fax_number": "844-457-8525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12107 Orsinger Ln",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782301413",
            "country_code": "US",
            "telephone_number": "210-995-3681",
            "fax_number": "210-693-1163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICHINSKI",
        "first_name": "KEITH",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MSN, PMC,FNP-C, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "612139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Henry Wholey, MD
• Kevin J Whritenour, AU.D
• Beverly Ann Wiatrek, O.D.
• Kirsten Leigh Wiatrek
• Zachary Austin Wiberg, DO
• Beth Ann Wichman, MD
• Pendleton Brewster Wickersham, M.D.
• Nicolette Anne Wickes
• Stephanie Wickizer, RN
• Matthew Paul Wicklund, M.D.

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.