Individual provider Active NPI

William L Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, MO
National Provider Identifier
1063571933
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
132482 Issued in MO
Practice address
1106 Yiotis Way
Columbia, MO 65203-6660
Phone
(573) 673-6861
Fax
(573) 443-2905
NPI assigned
Dec 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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 132482 MO Primary

Addresses

Primary practice location

1106 Yiotis Way
Columbia, MO 65203-6660

Mailing address

1106 Yiotis Way
Columbia, MO 65203-6660
Phone (573) 673-6861

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808002030 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901849991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Colleagues KS PAGroup PAC ID 3870921984, 44 clinicians

Practice addresses (Care Compare)

3001 Ave a
Dodge City, KS 67801-2270
Phone (850) 985-9180

Hospital & facility affiliations

  • Neosho Memorial Regional Medical Center Hospital, Chanute, KS, CCN 171380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132482MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Colleagues Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 5, 2025 Accepting new patients
Clinical Colleagues KS PA Nurse Anesthetist, Certified Registered CurrentSince Aug 7, 2023 Accepting new patients
Mid-America Anesthesia Consultants, PC Past Accepting new patients
St John'S Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
St Johns Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

629 S Plummer Ave
Chanute, KS 66720
Phone (316) 431-4000

3001 Avenue A
Dodge City, KS 67801
Phone (620) 225-8400

1 Stiles Rd
Ste 301
Salem, NH 03079

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1063571933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 YIOTIS WAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036660",
            "telephone_number": "573-673-6861",
            "fax_number": "573-443-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 YIOTIS WAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036660",
            "telephone_number": "573-673-6861",
            "fax_number": "573-443-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "132482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.