Individual provider Active NPI

Kathleen R. Wren, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston-Salem, NC
National Provider Identifier
1093760043
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP 9263820 Issued in FL
Practice address
Medical Center Drive
Nurse Anesthesia Program
Winston-Salem, NC 27157-0001
Phone
(407) 303-9331
Fax
(407) 303-9578
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP03921 LA
Certified Registered Nurse Anesthetist 367500000X ARNP 9263820 FL Primary

Addresses

Primary practice location

Medical Center Drive
Nurse Anesthesia Program
Winston-Salem, NC 27157-0001

Mailing address

2479 Ponkan Summit Dr
Apopka, FL 32712-6415
Phone (336) 716-1415

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

State licenses

LicenseStateTypeSpecialty
ARNP 9263820FLMDCertified Registered Nurse Anesthetist
AP03921LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta University Past Accepting new patients
Rockdale Anesthesia Services, P.C. PastSince Mar 1, 2003 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1093760043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2479 PONKAN SUMMIT DR",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327126415",
            "telephone_number": "336-716-1415",
            "fax_number": "336-716-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER DRIVE",
            "address_2": "NURSE ANESTHESIA PROGRAM",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "407-303-9331",
            "fax_number": "407-303-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "KATHLEEN",
        "middle_name": "R.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP03921",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 9263820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.