Wichita Medical Anesthesia LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

WICHITA MEDICAL ANESTHESIA LLC

Practice address

3617 W Gore Blvd Ste C
Lawton, OK 73505-6373

Phone

(580) 351-0500

Fax

(580) 351-0564

NPI assigned

Jul 15, 2020

Organization subpart

No

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

Authorized official

Name

Starla Ross

Title

Administrator

Phone

(580) 351-0500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John W Dew II, CRNA

  • Certified Registered Nurse Anesthetist
  • Lawton, OK
  • NPI 1316939960

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Roger D Hanley, CRNA

  • Certified Registered Nurse Anesthetist
  • Lawton, OK
  • NPI 1588656235

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Bradley Maples

  • Certified Registered Nurse Anesthetist
  • Lawton, OK
  • NPI 1891235271

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Dale B Smith, DO

  • Otolaryngology Physician
  • Lawton, OK
  • NPI 1083660369
  NPD
• Bryan Cain

  • Podiatrist
  • Lawton, OK
  • NPI 1336284595
  NPD (past)

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1083222137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 W GORE BLVD STE C",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056373",
            "telephone_number": "580-351-0500",
            "fax_number": "580-351-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 W GORE BLVD STE C",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056373",
            "telephone_number": "580-351-0500",
            "fax_number": "580-351-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA MEDICAL ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "STARLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-351-0500"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Whitlock, MS, LPC
• Lakayla M Whitmore
• Justin Whitney
• Sarah Whittington, R.N.
• Wichita Counseling Center
• Kori Wren Wiegmann, RN
• Bailey E Wiggins, DO
• Manuela Wikinger-Henry, MS,MHP,LMFT UNDER SU
• Nicole Lee Wilbanks
• Cali Wilcox

• Certified Registered Nurse Anesthetist in Lawton, OK
• Providers in Lawton, OK by specialty
• Certified Registered Nurse Anesthetist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.