Bruce Anthony Wilburn, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

9264869 Issued in FL

Practice address

2165 Herschel St
Jacksonville, FL 32204-3819

Phone

(904) 387-1220

NPI assigned

Jan 29, 2013

Sex

Male

Sole proprietor

No

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

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Digestive Disease ConsultantsGroup PAC ID 1850515040, 18 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Digestive Disease Consultants

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1710251921

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• American Physicians Foundation Corporation

  dba digestive disease foundation

  • Specialist
  • Jacksonville, FL
  • NPI 1922013754
  Medicare reassignment NPD
• North Florida Anesthesia Consultants, Inc.

  • Anesthesiology Physician
  • St Augustine, FL
  • NPI 1114892361
  NPD (past)

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1013255819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044416",
            "telephone_number": "904-388-5265",
            "fax_number": "904-387-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043819",
            "telephone_number": "904-387-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN",
        "first_name": "BRUCE",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-29",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9264869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Robert Wikstrom, MD
• Jeremy S. Wilbanks, PA-C
• Nishauna E Wilbert, LCSW
• Ashley Wilborn
• Catherine Cabell Wilbraham, MPT
• Sameka Wilburn
• Tyler Wilburn, CRNA
• Abigail Wilcox, MSN, CPNP-PC
• Chandler Curtis Wilcox, MD
• Jennell Wilcox, COTA

• Certified Registered Nurse Anesthetist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.