Individual provider Active NPI

William C Wilbur, CRNA

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
National Provider Identifier
1154626703
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9167040 Issued in FL
Practice address
801 E 6TH St
Suite 205
Panama City, FL 32401-3661
Phone
(850) 785-3185
Fax
(850) 785-6233
NPI assigned
Jan 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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 9167040 FL Primary

Addresses

Primary practice location

801 E 6TH St
Suite 205
Panama City, FL 32401-3661

Mailing address

801 E 6TH St
Suite 205
Panama City, FL 32401-3661
Phone (850) 785-3185

Other identifiers 1

IdentifierTypeStateIssuer
9167040OtherFLLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140605000470 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567645732 Reassigns benefits to 4 organizations

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

State licenses

LicenseStateTypeSpecialty
9167040FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Arlington Anesthesia Group, PLLC CurrentSince Mar 19, 2019 Accepting new patients
Pueblo Pathology Group, PC Current Accepting new patients
Epix Anesthesia of Colorado Springs, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 22, 2024 Accepting new patients
Amel Med, LLC CurrentSince Aug 1, 2018 Accepting new patients
Epix Anesthesia of Colorado Springs, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 22, 2024 Accepting new patients
Novamed Surgery Center of Colorado Springs, LLC Past Accepting new patients

Locations

2940 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 635-7321

10520 El Diente Ct
Ste A
Englewood, CO 80112
Phone (720) 414-5310

2460 Patterson Rd
Unit 4
Grand Junction, CO 81505
Phone (970) 245-0990

1000 Wellington Ave
Grand Junction, CO 81501
Phone (970) 243-9000

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

Organizations & group practices 7

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": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1154626703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E 6TH ST",
            "address_2": "SUITE 205",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013661",
            "telephone_number": "850-785-3185",
            "fax_number": "850-785-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E 6TH ST",
            "address_2": "SUITE 205",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013661",
            "telephone_number": "850-785-3185",
            "fax_number": "850-785-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBUR",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9167040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "9167040",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.