William G Chisholm Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30001327 Issued in WA

Practice address

174 1St Ave N
Ilwaco, WA 98624-9137

Phone

(360) 642-3181

NPI assigned

Jul 3, 2006

Last updated

Feb 2, 2016By 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

74.5 of 100Reported as group

Quality

70

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lourdes Hospital LLC

  dba Lourdes Counseling Center

  • Psychiatric Hospital
  • Richland, WA
  • NPI 1548342181
  NPD (past)
• Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC

  dba Premier Anesthesia of Richland

  • Anesthesiology Physician
  • Richland, WA
  • NPI 1013940253

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Surgical Center Anesthesiologists

  • Anesthesiology Physician
  • Kirkland, WA
  • NPI 1912002528
  NPD (past)
• Surgical Center Anesthesiologists, PLLC

  • Anesthesiology Physician
  • Shoreline, WA
  • NPI 1861061731
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1396775938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 E TAMARACK LN",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985849402",
            "telephone_number": "360-427-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 1ST AVE N",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "986249137",
            "telephone_number": "360-642-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30001327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210785",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "430073112",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9603887",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roderick William Beaver, MD
• Johnny Stephen Bell, DO
• Steven L Bellinger, PA C
• Tiffany Arden Bryce, MA, NBCC, LPC
• Jeffrey J Chabot, RPH
• City of Ilwaco (Ilwaco Fire Department)
• Jessica Clark
• Brent Lawrence Corvalan, MA
• Discovery Coast Emergency Physicians LLC
• Edouard J Duret, MD

• Certified Registered Nurse Anesthetist in Ilwaco, WA
• Providers in Ilwaco, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.