Individual provider Active NPI

Joe Wright, CRNA

  • Certified Registered Nurse Anesthetist
  • Lake Village, AR
National Provider Identifier
1164496469
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R32806 Issued in AR
Practice address
2729 S Highway 65 82
Lake Village, AR 71653-6136
Phone
(870) 265-5351
Fax
(870) 265-9306
NPI assigned
Feb 14, 2006
Last updated
Mar 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 R32806 AR Primary

Addresses

Primary practice location

2729 S Highway 65 82
Lake Village, AR 71653-6136

Mailing address

2729 S Highway 65 82
Lake Village, AR 71653-6136
Phone (870) 265-5351

Other identifiers 2

IdentifierTypeStateIssuer
115534701MedicaidAR
59537OtherARBLUE CROSS OF AR

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

State licenses

LicenseStateTypeSpecialty
R32806ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Memorial Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/deltamh-91f47cd8

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1164496469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2729 S HIGHWAY 65 82",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716536136",
            "telephone_number": "870-265-5351",
            "fax_number": "870-265-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 S HIGHWAY 65 82",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716536136",
            "telephone_number": "870-265-5351",
            "fax_number": "870-265-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JOE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R32806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115534701",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AR",
            "identifier": "59537",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Village, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.