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MS. KIMBERLY A MANCILLA SA-C
NPI 1588966840
Specialist/Technologist, Other - Surgical Assistant in Normal, IL

Active since November 18, 2010
1604 VISA DR, SUITE 1, NORMAL, IL 61761(309) 846-4716(309) 454-1107 Get Directions Write a Review

NPPES record last updated: July 29, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 29, 2020, Oct 16, 2018 (2 updates tracked since 2018).

About Ms. Kimberly A Mancilla Sa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KIMBERLY A MANCILLA SA-C (NPI 1588966840) is an individual surgical assistant in Normal, Illinois and active in the NPI registry since November 2010.

NPPES Registry Identity

NPI1588966840
Entity TypeIndividualFemale
Primary Taxonomy246ZC0007X
Provider Legal NameMS. KIMBERLY A MANCILLACredential: SA-C
Location Address1604 VISA DR, SUITE 1Normal, IL 61761-2195
Mailing Address1604 Visa Dr Ste 1Normal, IL 61761-2195 · (309) 846-4716 · Fax (309) 454-7348
Phone(309) 846-4716
Fax(309) 454-1107
Sole ProprietorNo
Enumeration DateNovember 18, 2010
Last NPPES UpdateJuly 29, 20202 updates tracked since enumeration
NPPES CertifiedJuly 29, 2020
✔ NPI 1588966840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist, Other · Surgical AssistantTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246ZC0007X
Definition
A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training.
1604 VISA DR, Normal, IL 61761
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IVY MEGAN PAIGE CST
1604 VISA DR, STE. 2
NORMAL, IL 61761
McLean County (309) 846-4716
DEBBIE BESSENT CST
Specialist/Technologist, Other (Surgical Assistant)
1604 VISA DR, SUITE #1
NORMAL, IL 61761
McLean County (309) 846-4716
SHERRY FULK
1604 VISA DR, SUITE 1
NORMAL, IL 61761
McLean County (309) 846-4716
MR. MICHAEL HANSEN CST
Specialist/Technologist, Other (Surgical Technologist)
1604 VISA DR, STE 1
NORMAL, IL 61761
McLean County (309) 846-4716
MARGARET BOYER CST, CFA
1604 VISA DR, STE. 2
NORMAL, IL 61761
McLean County (309) 846-4716
SUSAN RIBORDY
Specialist/Technologist, Other (Electroneurodiagnostic)
1604 VISA DR, SUITE 1
NORMAL, IL 61761
McLean County (309) 454-1100
JODI RAPPA CST, RST
Physician Assistant (Surgical)
1604 VISA DR, STE. 2
NORMAL, IL 61761
McLean County (309) 846-4716
DENA BINEGAR
1604 VISA DR, SUITE 1
NORMAL, IL 61761
McLean County (309) 846-4716

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Mancilla's NPI number?

The NPI number for Kimberly Mancilla is 1588966840. It was assigned to this individual provider in the NPPES registry on November 18, 2010.

Where is Kimberly Mancilla located?

Kimberly Mancilla practices at 1604 Visa Dr Suite 1, Normal, IL 61761. The listed phone number is (309) 846-4716.

What is Kimberly Mancilla's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other, specializing in Surgical Assistant, with taxonomy code 246ZC0007X.

When was this NPI record last updated?

The NPPES record for Kimberly Mancilla was last updated on July 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.