NPIMap

Organization Active NPI

Northwest Anesthesiology Sa, P.a.

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1366489262
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTHWEST ANESTHESIOLOGY SA, P.A.
Practice address
45 NE Loop 410
Suite 900
San Antonio, TX 78216-5832
Phone
(210) 375-7780
Fax
(210) 375-7789
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Dr. James Michael Wynn, MDNPI 1083652374
Title
Partner
Phone
(210) 477-2409

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

45 NE Loop 410
Suite 900
San Antonio, TX 78216-5832

Mailing address

45 NE Loop 410
Suite 900
San Antonio, TX 78216-5832
Phone (210) 375-7780

Other identifiers 1

IdentifierTypeStateIssuer
180298501MedicaidTX

National Provider Directory

National Provider Directory

Locations

12702 N Interstate 35
Live Oak, TX 78233
Phone (210) 650-9669

4402 Vance Jackson Rd
Ste 220
San Antonio, TX 78230
Phone (210) 477-2409

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1366489262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NE LOOP 410",
            "address_2": "SUITE 900",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165832",
            "telephone_number": "210-375-7780",
            "fax_number": "210-375-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NE LOOP 410",
            "address_2": "SUITE 900",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165832",
            "telephone_number": "210-375-7780",
            "fax_number": "210-375-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ANESTHESIOLOGY SA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "210-477-2409",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180298501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.