Individual provider Active NPI

William Brian Dumas, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Port Huron, MI
National Provider Identifier
1235187592
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704252609 Issued in MI
Practice address
1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone
(810) 987-5000
Fax
(810) 985-2633
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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 4704252609 MI Primary

Addresses

Primary practice location

1221 Pine Grove Ave
Port Huron, MI 48060-3511

Mailing address

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

Other identifiers 2

IdentifierTypeStateIssuer
8051830MedicaidNC
4704252609OtherMILICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000597 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577654862 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Medical Group PAGroup PAC ID 6800874322, 99 clinicians

Practice addresses (Care Compare)

2601 Lake Dr
Suite 201
Raleigh, NC 27607-6689
Phone (919) 783-4888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704252609MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Williamston Clinic Corp CurrentSince Oct 21, 2019 Accepting new patients
Raleigh Medical Group, PA CurrentSince Jul 17, 2020 Accepting new patients
Anesthesia Care Services, PA Nurse Anesthetist, Certified Registered CurrentSince Jun 26, 2020 Accepting new patients
Mercy Tyler Hospital Past Accepting new patients
Lenoir Memorial Hospital, Incorporated Past Accepting new patients
Mercy Tyler Health Systems Past Accepting new patients
Lenoir Memorial Hospital, Incorporated Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2730 Georgia Rd
Franklin, NC 28734
Phone (828) 349-3636

2705 Medical Office Pl
Goldsboro, NC 27534
Phone (919) 580-9111

3735 Admiral Dr
Ste 111
High Point, NC 27265
Phone (336) 821-4180

2601 Lake Dr
Ste 201
Raleigh, NC 27607
Phone (919) 783-4888

3521 Haworth Dr
Raleigh, NC 27609
Phone (919) 782-1806

104 Medical Dr
Williamston, NC 27892
Phone (252) 809-6300

310 S McCaskey Rd
Williamston, NC 27892
Phone (252) 809-6133

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1235187592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-987-5000",
            "fax_number": "810-985-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-987-5000",
            "fax_number": "810-985-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAS",
        "first_name": "WILLIAM",
        "middle_name": "BRIAN",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704252609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051830",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "4704252609",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.