Active NPI
Wilson H. Wessells Jr., CRNA
- Certified Registered Nurse Anesthetist
- Fort Collins, CO
National Provider Identifier
1023006228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CRA-832
- Practice address
- 1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000 - Phone
- (970) 224-2985
- Fax
- (970) 472-9381
- NPI assigned
- Oct 11, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 66486 | CO | |
| Certified Registered Nurse Anesthetist | 367500000X | CRA-832 | CO | Primary |
Addresses
Primary practice location
1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Mailing address
1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone (970) 224-2985
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07664865 | Medicaid | CO | |
| 101049200 | Medicaid | WY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66486 | CO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Colorado Anesthesia Professionals PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Fort Collins, CO
- NPI 1851389613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310601600000",
"number": "1023006228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1236 E ELIZABETH ST",
"address_2": "SUITE 1",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805244000",
"telephone_number": "970-224-2985",
"fax_number": "970-472-9381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1236 E ELIZABETH ST",
"address_2": "SUITE 1",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805244000",
"telephone_number": "970-224-2985",
"fax_number": "970-472-9381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESSELLS",
"first_name": "WILSON",
"middle_name": "H.",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2011-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CO",
"license": "66486",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CO",
"license": "CRA-832",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07664865",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101049200",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.