Individual provider Active NPI

William Robert Wasik, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Cloud, MN
National Provider Identifier
1427172444
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
023087 Issued in MN
Practice address
1526 Northway Dr
Saint Cloud, MN 56303-1255
Phone
(320) 251-8385
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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 023087 MN Primary

Addresses

Primary practice location

1526 Northway Dr
Saint Cloud, MN 56303-1255

Mailing address

20910 134TH St NE
Hawick, MN 56273-7761
Phone (320) 251-8385

Other identifiers 1

IdentifierTypeStateIssuer
P00292690OtherMNMEDICARE RAILROAD

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
0470SDMDPhysical Therapist
023087MNMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1427172444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20910 134TH ST NE",
            "city": "HAWICK",
            "state": "MN",
            "postal_code": "562737761",
            "telephone_number": "320-251-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 NORTHWAY DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031255",
            "telephone_number": "320-251-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIK",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "023087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00292690",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.