NPIMap

Organization Active NPI

Wilson Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
National Provider Identifier
1104178482
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
WILSON ANESTHESIA ASSOCIATES LLC
Practice address
2430 Brookstone Centre Pkwy
Columbus, GA 31904-4501
Phone
(706) 494-7700
Fax
(706) 494-8800
NPI assigned
Oct 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Authorized official

Name
Mr. Charles D WilsonNPI 1730146309
Title
President
Phone
(706) 957-2782

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

2430 Brookstone Centre Pkwy
Columbus, GA 31904-4501

Mailing address

PO Box 8866
Greensboro, NC 27419-0866
Phone (336) 553-1659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121126000110 GA Part B Supplier - Clinic/Group Practice 5698926673 Receives reassigned benefits from 18 practitioners
Practice locations: Atlanta, GA; Columbus, GA
O20240201004319 AL Part B Supplier - Clinic/Group Practice 5698926673 Receives reassigned benefits from 8 practitioners
Practice locations: Eufaula, AL

National Provider Directory

National Provider Directory

Locations

2807 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 402-4107

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1104178482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8866",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274190866",
            "telephone_number": "336-553-1659",
            "fax_number": "336-553-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044501",
            "telephone_number": "706-494-7700",
            "fax_number": "706-494-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON ANESTHESIA ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-957-2782",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.