Individual provider Active NPI

Kathy Marie Wolverton, CRNA

  • Certified Registered Nurse Anesthetist
  • Advance, NC
National Provider Identifier
1023092921
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
075728 Issued in NC
Practice address
111 Country Cir
Advance, NC 27006-7456
Phone
(336) 998-7590
NPI assigned
Dec 5, 2005
Last updated
Oct 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 075728 NC Primary

Addresses

Primary practice location

111 Country Cir
Advance, NC 27006-7456

Mailing address

111 Country Cir
Advance, NC 27006-7456
Phone (336) 998-7590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100913000242 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547385783 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Services PAGroup PAC ID 7012937105, 54 clinicians

Practice addresses (Care Compare)

2705 Medical Office PL
Goldsboro, NC 27534-9458
Phone (919) 731-2526

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
075728NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2015 Accepting new patients
Anesthesia Care Services, PA Nurse Anesthetist, Certified Registered CurrentSince May 1, 2022 Accepting new patients

Locations

2730 Georgia Rd
Franklin, NC 28734
Phone (828) 349-3636

2705 Medical Office Pl
Goldsboro, NC 27534
Phone (919) 580-9111

223 Hospital St
Mocksville, NC 27028
Phone (336) 751-8100

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 3

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1023092921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COUNTRY CIR",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270067456",
            "telephone_number": "336-998-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COUNTRY CIR",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270067456",
            "telephone_number": "336-998-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLVERTON",
        "first_name": "KATHY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "075728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Advance, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.