Traci Renee Wilmarth, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

100545 Issued in OK

Practice address

9713 Lakecrest Dr
Oklahoma City, OK 73159-6777

Phone

(405) 213-5351

NPI assigned

Nov 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Plains Medical Center IncGroup PAC ID 5991618969, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: traci.wilmarth.1@32697.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/HDHGCD/Endpoint/HDHGCD

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.

• Southern Plains Medical Center Inc

  • Clinic/Center
  • Chickasha, OK
  • NPI 1962469098
  Medicare reassignment Care Compare group NPD
• Digestive Disease Specialists Inc

  • Gastroenterology Physician
  • Oklahoma City, OK
  • NPI 1366489213
  Medicare reassignment
• Southern Plains Medical Center Inc

  • Clinic/Center
  • Anadarko, OK
  • NPI 1255357745
  NPD
• Southern Plains Medical Center Inc

  • Clinic/Center
  • Norman, OK
  • NPI 1881499655
  NPD
• Hatton Anesthesia LLC

  • Anesthesiology Physician
  • Tulsa, OK
  • NPI 1659922201
  NPD (past)

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1003245481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9713 LAKECREST DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596777",
            "telephone_number": "405-213-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9713 LAKECREST DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596777",
            "telephone_number": "405-213-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMARTH",
        "first_name": "TRACI",
        "middle_name": "RENEE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "100545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003245481",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Markie J Willoughby, PRSS
• Willow ABA Services LLC
• Willow Birth Services
• Willow Path Therapy LLC
• Betina Wills
• Brooke Piland Wilmore, MD
• Travis Hammett Wilmore, MD
• Alexis Wilmoth
• Larry Dean Wilmoth
• Susan Lynne Wilmoth, M.H.R.

• Certified Registered Nurse Anesthetist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Certified Registered Nurse Anesthetist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.