Nickolas K Willard, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRNA1186 Issued in AZ

Practice address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Phone

(480) 301-8000

NPI assigned

Dec 9, 2010

Last updated

Apr 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Amsurg North Valley Anesthesia LLCGroup PAC ID 7416121447, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nickolaswillard@asjh.medalliesdirect.net

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.

• Amsurg North Valley Anesthesia LLC

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1629351788
  Medicare reassignment Care Compare group NPD
• Cac Anesthesia Services PLLC

  • Certified Registered Nurse Anesthetist
  • Tempe, AZ
  • NPI 1043056518

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• North Valley Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Phoenix, AZ
  • NPI 1043239338
  Medicare reassignment NPD
• Trojan Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Tempe, AZ
  • NPI 1750817300

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Virtuous Anesthesia

  • Anesthesiology Physician
  • Tempe, AZ
  • NPI 1881168656
  Medicare reassignment NPD
• VS Anesthesia Services PLLC

  • Certified Registered Nurse Anesthetist
  • Tempe, AZ
  • NPI 1487538294

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Arizona Spine and Joint Hospital LLC

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1396745832
  NPD
• Laser Spine Institute of Arizona, LLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1174778484
  NPD (past)

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1073816237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St # F5-704",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112908",
            "country_code": "US",
            "telephone_number": "801-710-2006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "NICKOLAS",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-09",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209010303",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA1186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Keith Wilkinson, NMD
• Erin Wilkinson, MSW, LCSW
• Joel Wilkinson, PT
• Sharon Wilkinson
• Will2Walk Homecare Services, LLC
• Aaron Willardson, MOTR/L
• Emma Janice Willcocks, MD
• Bradley J Willcox, D.M.D.
• Keiko H Willcox, DDS DMD PHD
• Catherine Willenborg, PAC

• Certified Registered Nurse Anesthetist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.