Individual provider Active NPI

William J Niewieroski Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Watertown, NY
National Provider Identifier
1124046024
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
277507 Issued in NY
Practice address
830 Washington St
Watertown, NY 13601-4066
Phone
(315) 785-8509
Fax
(315) 785-8619
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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 277507 NY Primary

Addresses

Primary practice location

830 Washington St
Watertown, NY 13601-4066

Mailing address

445 Factory St
PO Box 91
Watertown, NY 13601-2729
Phone (315) 782-4207

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1124046024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 FACTORY ST",
            "address_2": "PO BOX 91",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012729",
            "telephone_number": "315-782-4207",
            "fax_number": "315-782-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014066",
            "telephone_number": "315-785-8509",
            "fax_number": "315-785-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEWIEROSKI",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "277507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.