Individual provider Active NPI

Candace Lynn Wills, CRNA

  • Certified Registered Nurse Anesthetist
  • Wausau, WI
National Provider Identifier
1366739443
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11608-33 Issued in WI
Practice address
411 Westwood Dr
Wausau, WI 54401-4152
Phone
(715) 847-2558
Fax
(715) 261-6452
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041319033 IL
Certified Registered Nurse Anesthetist 367500000X 041319033 IL
Certified Registered Nurse Anesthetist 367500000X 11608-33 WI Primary

Addresses

Primary practice location

411 Westwood Dr
Wausau, WI 54401-4152

Mailing address

411 Westwood Dr
Wausau, WI 54401-4152
Phone (715) 847-2558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111003000753 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002088606 Reassigns benefits to 1 organization
I20211213001870 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002088606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
R Franklin University of Med & Sci/Chicago Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Associates S.C.Group PAC ID 4385677814, 42 clinicians

Practice addresses (Care Compare)

411 Westwood Dr
Wausau, WI 54401-4152
Phone (715) 847-2558

Merit-based Incentive Payment System (MIPS)

Final score
90.86 of 100Reported as group
Quality
86.95
Promoting interoperability
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041319033ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Associates S.C. CurrentSince Dec 3, 2021 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

411 Westwood Dr
Wausau, WI 54401
Phone (715) 479-0374

Organizations & group practices 4

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1366739443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WESTWOOD DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014152",
            "telephone_number": "715-847-2558",
            "fax_number": "715-261-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WESTWOOD DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014152",
            "telephone_number": "715-847-2558",
            "fax_number": "715-261-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "CANDACE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041319033",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041319033",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "11608-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.