William Wieties, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

102562 Issued in MO

Practice address

300 W 27TH St
Lumberton, NC 28358-3075

Phone

(910) 671-5000

Fax

(910) 738-3764

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlantic Coast Anesthesia Services PCGroup PAC ID 3971887167, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Atlantic Coast Anesthesia Services P.C.

  • Anesthesiology Physician
  • Myrtle Beach, SC
  • NPI 1932641313

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Beach Anesthesia, LLC

  • Anesthesiology Physician
  • Myrtle Beach, SC
  • NPI 1215061429
  Medicare reassignment NPD
• Conway Anesthesia Services Inc

  • Anesthesiology Physician
  • Conway, SC
  • NPI 1316540636

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  NC, SC

  Medicare reassignment
• Southeastern Regional Medical Center

  • Urgent Care Clinic/Center
  • Lumberton, NC
  • NPI 1063779114
  NPD (past)
• Southeastern Regional Medical Center

  • Hearing Aid Equipment
  • Lumberton, NC
  • NPI 1871735019
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1104958412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N ELM ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583011",
            "telephone_number": "910-671-5290",
            "fax_number": "910-738-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583075",
            "telephone_number": "910-671-5000",
            "fax_number": "910-738-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETIES",
        "first_name": "WILLIAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "102562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "913284816",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104958412",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce S. Whitman, D.O.
• Candice Whittington
• Rosaline Whittington
• Gina Marie Whritenour, DNP, FNP-C, MSN, RN
• Wiani LLC Dba Anchorpointe Recovery and Wellness
• Ashley Rose Wilhelm, LCSW, LCAS
• Jessabel Noel Willard, OTR/L
• Brittnee S Williams, FNP/ENP
• Courtney Flores Williams, LCSW-A
• D'Niqua Williams, DPT

• Certified Registered Nurse Anesthetist in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.