Stephen Wesley Wilson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R063574 Issued in MD

Practice address

10751 Falls Rd
Suite 425
Lutherville, MD 21093-4517

Phone

(410) 583-2760

Fax

(410) 583-2759

NPI assigned

Aug 22, 2005

Last updated

Nov 5, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• North American Partners in Anesthesia Maryland LLC

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1093707879
  Medicare reassignment NPD
• North Calvert Anesthesiology Services LLC

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1710360227
  Medicare reassignment NPD
• Glen Elyn Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Lutherville, MD
  • NPI 1831391036
  Authorized official Same address or phone
• Poole Endoscopy Center

  dba Neel Kamal MD

  • Ambulatory Surgical Clinic/Center
  • Westminster, MD
  • NPI 1669668943
  NPD (past)
• Warren H Macleod C R N a PA

  • Certified Registered Nurse Anesthetist
  • Towson, MD
  • NPI 1457433591

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1255323630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 MORNINGSIDE CT",
            "city": "BALDWIN",
            "state": "MD",
            "postal_code": "210139528",
            "telephone_number": "410-557-6724",
            "fax_number": "410-557-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10751 FALLS RD",
            "address_2": "SUITE 425",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934517",
            "telephone_number": "410-583-2760",
            "fax_number": "410-583-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHEN",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R063574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "KCE3GL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00012294",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "876R",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL CAREFIRST",
            "identifier": "S4320001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William E. Randall, Jr., M.D. P.a.
• William J. Ravich, M.D., L.L.C.
• Eric Q Williams, OD
• Mark Frederic Williams, M.D.
• Javon Mytira Willis
• Adona Irene Wimberly, PH.D., L.C.A.D.C.
• Windrush Behavioral Health, LLC
• Windrush Behavioral Health, LLC
• Amy Link Winkelstein, M.D.
• Charles A Winternitz, MD

• Certified Registered Nurse Anesthetist in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.