Individual provider Active NPI

Edward T Wilkins, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
National Provider Identifier
1265473078
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9215859 Issued in FL
Practice address
719 E New Haven Ave
Melbourne, FL 32901-5459
Phone
(321) 726-4024
Fax
(321) 984-9547
NPI assigned
Jun 10, 2006
Last updated
May 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN326069L PA
Certified Registered Nurse Anesthetist 367500000X 2511 SC
Certified Registered Nurse Anesthetist 367500000X ARNP9215859 FL Primary
Registered Nurse 163W00000X RN326069L PA

Addresses

Primary practice location

719 E New Haven Ave
Melbourne, FL 32901-5459

Mailing address

812 Topaz Dr
Rockledge, FL 32955-4035
Phone (321) 637-9197

Other identifiers 2

IdentifierTypeStateIssuer
44192443603MedicaidPA
306717300MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
RN326069LPAMDCertified Registered Nurse Anesthetist
2511SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Institute Surgery Center, LLC CurrentSince Sep 10, 2023 Accepting new patients
Central Brevard Anesthesiologists, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Brevard Anesthesia Services PA Registered Nurse PastSince Dec 1, 1999 Accepting new patients
Western Pennsylvania Anesthesia Associates, LTD. Past Accepting new patients
Butler Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Halifax Anesthesiology Associates PA Past Accepting new patients
Allegheny Clinic Past Accepting new patients
United Hospital Center, Inc. Past Accepting new patients
Ambulatory Surgery Center Support Services Past Accepting new patients
Brevard Physician Associates, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
The Stingl Family Foundation, Inc PastSince May 7, 2016 Accepting new patients

Locations

1995 W Nasa Blvd
Ste 100
Melbourne, FL 32904
Phone (321) 722-4443

1995 W Nasa Blvd
Melbourne, FL 32904
Phone (321) 674-3912

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1265473078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 TOPAZ DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554035",
            "telephone_number": "321-637-9197",
            "fax_number": "321-637-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 E NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015459",
            "telephone_number": "321-726-4024",
            "fax_number": "321-984-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "EDWARD",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN326069L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2511",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9215859",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN326069L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44192443603",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306717300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.