Individual provider Active NPI

Roni M Wilson, CRNA

  • Certified Registered Nurse Anesthetist
  • Minot, ND
National Provider Identifier
1124127972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R28873 Issued in ND
Practice address
1 Burdick Expy W
Minot, ND 58701-4406
Phone
(701) 857-5124
Fax
(701) 857-3264
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R28873 ND Primary

Addresses

Primary practice location

1 Burdick Expy W
Minot, ND 58701-4406

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131002904 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173627239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triangle Anesthesia Group, PSCGroup PAC ID 9436161585, 77 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Hazard, KY 41701-9421
Phone (606) 439-6600

3600 W Cumberland Ave
Middlesboro, KY 40965-2614
Phone (606) 242-1100

5000 Ky Route 321
Prestonsburg, KY 41653-9113
Phone (606) 886-8511

Hospital & facility affiliations

  • Highlands Arh Regional Medical Center Hospital, Prestonsburg, KY, CCN 180005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Anesthesia Group PSC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2023 Accepting new patients
Seminole Hospital District of Gaines County Texas Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2021 Accepting new patients
Seminole Hospital District of Gaines County Texas CurrentSince Oct 1, 2021 Accepting new patients
Seminole Hospital District of Gaines County Texas Past Accepting new patients

Locations

100 Medical Dr
Hazard, KY 41701
Phone (606) 439-6600

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

209 NW 8th St
Seminole, TX 79360
Phone (432) 758-5811

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124127972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5124",
            "fax_number": "701-857-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BURDICK EXPY W",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014406",
            "telephone_number": "701-857-5124",
            "fax_number": "701-857-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RONI",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R28873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.