Individual provider Active NPI

William John McGowan, CRNA

  • Certified Registered Nurse Anesthetist
  • Grand Rapids, MI
National Provider Identifier
1184636276
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704164495 Issued in MI
Practice address
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756
Phone
(616) 364-4200
Fax
(616) 364-7347
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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 4704164495 MI Primary

Addresses

Primary practice location

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756

Mailing address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756
Phone (616) 364-4200

Other identifiers 1

IdentifierTypeStateIssuer
4828282MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060124000706 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628092061 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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.

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Group CurrentSince Mar 30, 2024 Accepting new patients
Munson Healthcare Charlevoix Hospital Nurse Anesthetist, Certified Registered CurrentSince Oct 2, 2023 Accepting new patients
Munson Healthcare Charlevoix Hospital CurrentSince Oct 2, 2023 Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Medical Center Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2023 Accepting new patients
Munson Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Munson Healthcare Cadillac Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2023 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Charlevoix Hospital Current Accepting new patients
Munson Healthcare Cadillac CurrentSince Oct 30, 2023 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Oct 10, 2023 Accepting new patients
Munson Medical Group Nurse Anesthetist, Certified Registered CurrentSince Mar 30, 2024 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Cadillac Past Accepting new patients

Locations

3775 Momentum Pl
Chicago, IL 60689

2891 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

829 N Center Ave
Ste 210
Gaylord, MI 49735
Phone (989) 731-7860

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

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 and National Provider Directory roles.

View all 15

Hospital & facility affiliations 1

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1184636276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704164495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4828282",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.