Active NPI
Linda Rae Williams, CRNA
- Certified Registered Nurse Anesthetist
- Shady Spring, WV
National Provider Identifier
1215084785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 17263
- Practice address
- 127 Gilead St
Shady Spring, WV 25918-2004 - Phone
- (304) 763-6155
- Fax
- (304) 763-6156
- NPI assigned
- Jan 5, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 17263 | WV | Primary |
Addresses
Primary practice location
127 Gilead St
Shady Spring, WV 25918-2004
Mailing address
PO Box 2004
Shady Spring, WV 25918-2004
Phone (304) 763-6155
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 550771337001 | Other | WV | TRICARE |
| 001722480 | Other | WV | BLUE CROSS BLUE SHIELD |
| 5710351000 | Medicaid | WV |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17263 | WV | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215084785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2004",
"city": "SHADY SPRING",
"state": "WV",
"postal_code": "259182004",
"telephone_number": "304-763-6155",
"fax_number": "304-763-6156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 GILEAD ST",
"city": "SHADY SPRING",
"state": "WV",
"postal_code": "259182004",
"telephone_number": "304-763-6155",
"fax_number": "304-763-6156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "LINDA",
"middle_name": "RAE",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WV",
"license": "17263",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "550771337001",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "001722480",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5710351000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shady Spring, WV
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.