Individual provider Active NPI

William Baxter Waddill Rand, CRNA

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
National Provider Identifier
1447306394
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
172618 Issued in NC
Practice address
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone
(919) 784-3034
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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 172618 NC Primary

Addresses

Primary practice location

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Mailing address

3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 873-9533

Other identifiers 2

IdentifierTypeStateIssuer
P00281340OtherNCRAILROAD-MEDICARE
8052391MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051130000823 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204856636 Reassigns benefits to 2 organizations
I20180116001237 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204856636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Regional Anesthesia PLLCGroup PAC ID 5496921769, 51 clinicians
Carolina Anesthesia Associates PAGroup PAC ID 1456251057, 67 clinicians

Practice addresses (Care Compare)

3520 Airport Blvd NW
Suite E
Wilson, NC 27896-8674
Phone (252) 206-5622

5115 Oleander Dr
Wilmington, NC 28403-7018
Phone (910) 362-1011

704 WH Smith Blvd
Greenville, NC 27834-3761
Phone (828) 327-6673

945 82ND Pkwy
Suite 2
Myrtle Beach, SC 29572-4612
Phone (843) 839-0823

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
172618NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Anesthesia Associates PA Anesthesiology CurrentSince Jun 1, 2014 Accepting new patients
Carolina Regional Anesthesia PLLC Anesthesiology CurrentSince Jun 1, 2014 Accepting new patients

Locations

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

2210 Hemby Ln
Greenville, NC 27834
Phone (252) 551-3000

242A 9th Avenue Dr NE
Hickory, NC 28601
Phone (828) 327-6673

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

101 Surgeons Dr
Myrtle Beach, SC 29579
Phone (803) 504-7194

945 82nd Pkwy
Ste 2
Myrtle Beach, SC 29572
Phone (843) 839-0823

Organizations & group practices 2

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1447306394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD",
            "address_2": "SUITE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-873-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAND",
        "first_name": "WILLIAM",
        "middle_name": "BAXTER WADDILL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "172618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-MEDICARE",
            "identifier": "P00281340",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052391",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.