Individual provider Active NPI

Richard Wlosinski, CRNA

  • Certified Registered Nurse Anesthetist
  • Commerce Township, MI
National Provider Identifier
1508845793
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704132395 Issued in MI
Practice address
1 William Carls Dr
Commerce Township, MI 48382-2201
Phone
(248) 937-3307
NPI assigned
Jan 16, 2006
Last updated
Sep 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 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 4704132395 MI Primary

Addresses

Primary practice location

1 William Carls Dr
Commerce Township, MI 48382-2201

Mailing address

PO Box 67000
Dept 203401
Detroit, MI 48267-0002
Phone (952) 442-9770

Other identifiers 3

IdentifierTypeStateIssuer
104299998MedicaidMI
430062962OtherMIRAILROAD MEDICARE
RW132395OtherMIBLEU CROSS OF MI

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704132395MIMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1508845793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPT 203401",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670002",
            "telephone_number": "952-442-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822201",
            "telephone_number": "248-937-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLOSINSKI",
        "first_name": "RICHARD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704132395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104299998",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430062962",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLEU CROSS OF MI",
            "identifier": "RW132395",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.