Individual provider Active NPI

Christopher Clifton McWilliams, CRNA

  • Certified Registered Nurse Anesthetist
  • Newnan, GA
National Provider Identifier
1417022765
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN148179 Issued in GA
Practice address
80 Newnan Station Drive, Suite a
Newnan, GA 30265
Phone
(770) 251-2060
Fax
(678) 854-9235
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN148179 GA Primary

Addresses

Primary practice location

80 Newnan Station Drive, Suite a
Newnan, GA 30265

Mailing address

PO Box 73709
Newnan, GA 30271-3709
Phone (770) 251-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000515 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476442005 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN148179GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Crescent Anesthesiology, PC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2004 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Apr 24, 2014 Accepting new patients
Dekalb Anesthesia Associates, LLC Past Accepting new patients
Medical Center Medical Group Past Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

7351 Old Moon Rd
Columbus, GA 31909
Phone (706) 221-2721

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

3150 Highway 34 E
#195
Newnan, GA 30265

3150 Highway 34 E
Ste 195
Newnan, GA 30265

3150 Highway 34 E
Ste 197
Newnan, GA 30265

80 Newnan Station Dr
Ste A
Newnan, GA 30265

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1417022765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73709",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302713709",
            "telephone_number": "770-251-2060",
            "fax_number": "678-854-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 NEWNAN STATION DRIVE, SUITE A",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "770-251-2060",
            "fax_number": "678-854-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "CHRISTOPHER",
        "middle_name": "CLIFTON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN148179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.