Individual provider Active NPI

Wendy J. Gibson, CRNA

  • Certified Registered Nurse Anesthetist
  • Sunrise, FL
National Provider Identifier
1043285695
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP3115112 Issued in FL
Practice address
1613 Harrison Pkwy
#200
Sunrise, FL 33323-2853
Phone
(954) 838-2371
NPI assigned
Feb 17, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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 ARNP3115112 FL Primary

Addresses

Primary practice location

1613 Harrison Pkwy
#200
Sunrise, FL 33323-2853

Mailing address

PO Box 817737
Hollywood, FL 33081-1737

Other identifiers 1

IdentifierTypeStateIssuer
306916800MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wgibson13452@MHSDIRECT.NET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607000563 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830132240 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11011 Sheridan St
Suite 106
Hollywood, FL 33026-1501
Phone (305) 468-4185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP3115112FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 28, 2005 Accepting new patients
Galloway Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2017 Accepting new patients
South Florida Anesthesia & Pain Treatment, P.a. Nurse Anesthetist, Certified Registered CurrentSince Jan 29, 2013 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Feb 28, 2005 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Galloway Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2017 Accepting new patients
Flamingo Anesthesia Associates Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2008 Accepting new patients
Ahp of South Broward LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Sheridan Healthcare of Vermont Inc Nurse Anesthetist, Certified Registered PastSince Sep 25, 2019 Accepting new patients

Locations

3100 SW 37th Ave
Coral Gables, FL 33134
Phone (305) 441-6868

11011 Sheridan St
Ste 106
Hollywood, FL 33026
Phone (954) 435-0101

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313
Phone (866) 747-5834

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

7600 SW 87th Ave
Ste 100
Miami, FL 33173
Phone (786) 235-3750

9415 SW 72nd St
Ste 274
Miami, FL 33173
Phone (305) 468-4184

501 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 430-1700

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Interoperability endpoints

  • Direct secure messaging: wgibson13452@mhsdirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1043285695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817737",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330811737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 HARRISON PKWY",
            "address_2": "#200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232853",
            "telephone_number": "954-838-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "WENDY",
        "middle_name": "J.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3115112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306916800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wgibson13452@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "1613 Harrison Pkwy",
            "address_2": "#200",
            "city": "Sunrise",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333232853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.