Individual provider Active NPI

William Kenneth Trimble, CRNA

  • Certified Registered Nurse Anesthetist
  • Hanover, VA
National Provider Identifier
1083760730
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024170056 Issued in VA
Practice address
7307 Extreme Way
Hanover, VA 23069-1631
Phone
(623) 606-5439
Fax
(804) 415-7137
NPI assigned
Jan 26, 2007
Last updated
May 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2016

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 0024170056 VA Primary

Addresses

Primary practice location

7307 Extreme Way
Hanover, VA 23069-1631

Mailing address

7307 Extreme Way
Hanover, VA 23069-1631
Phone (623) 606-5439

Other identifiers 1

IdentifierTypeStateIssuer
493396MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Squaw Peak Anesthesia Inc Past Accepting new patients
Squaw Peak Anesthesia Inc Nurse Anesthetist, Certified Registered PastSince Sep 5, 2021 Accepting new patients
Care for Kids of Arizona Past Accepting new patients

Organizations & group practices 4

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1083760730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7307 EXTREME WAY",
            "city": "HANOVER",
            "state": "VA",
            "postal_code": "230691631",
            "telephone_number": "623-606-5439",
            "fax_number": "804-415-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7307 EXTREME WAY",
            "city": "HANOVER",
            "state": "VA",
            "postal_code": "230691631",
            "telephone_number": "623-606-5439",
            "fax_number": "804-415-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMBLE",
        "first_name": "WILLIAM",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024170056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493396",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.