Individual provider Active NPI

Wendy Jo Plum, CRNA

  • Certified Registered Nurse Anesthetist
  • Lufkin, TX
National Provider Identifier
1174591523
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP 2721072 Issued in FL
Practice address
3009 S John Redditt Dr # 168
Lufkin, TX 75904-5661
Phone
(808) 222-1712
NPI assigned
Mar 10, 2006
Last updated
Jan 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN243133 OH
Certified Registered Nurse Anesthetist 367500000X ARNP 2721072 FL Primary

Addresses

Primary practice location

3009 S John Redditt Dr # 168
Lufkin, TX 75904-5661

Mailing address

3009 S John Redditt
#168
Lufkin, TX 75901
Phone (808) 222-1712

Other identifiers 1

IdentifierTypeStateIssuer
101120525MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060505000836 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820989569 Reassigns benefits to 2 organizations
I20061215000003 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820989569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Port St Lucie Anesthesia LLCGroup PAC ID 2769743343, 4 clinicians

Practice addresses (Care Compare)

1715 SE Tiffany Ave
Port St Lucie, FL 34952-7511
Phone (772) 335-7005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ARNP 2721072FLMDCertified Registered Nurse Anesthetist
RN243133OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Anesthesia Group Inc CurrentSince Sep 28, 2019 Accepting new patients
FMFL Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince May 11, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince May 11, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Lexington Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
North Texas Anesthesiology,PLLC PastSince Jul 10, 2006 Accepting new patients
Beaumont Hospital Holdings Inc Past Accepting new patients
Peace River Anesthesiology Associates PA Past Accepting new patients
Medical Anesthesia and Pain Management Consultants, P.a. PastSince May 1, 2015 Accepting new patients
Anesthesia Associates of York PA Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Blair County Anesthesia, P.C. Past Accepting new patients
Hendrick Anesthesia Network Past Accepting new patients
Jennifer Sassi PA Nurse Anesthetist, Certified Registered PastSince Feb 5, 2014 Accepting new patients

Locations

6820 International Center Blvd
Fort Myers, FL 33912
Phone (239) 210-0301

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

1575 S Beretania St
Ste 201-202
Honolulu, HI 96826
Phone (808) 352-2081

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1174591523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 S JOHN REDDITT",
            "address_2": "#168",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "75901",
            "telephone_number": "808-222-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 S JOHN REDDITT DR # 168",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045661",
            "telephone_number": "808-222-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUM",
        "first_name": "WENDY",
        "middle_name": "JO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN243133",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 2721072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101120525",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.