Individual provider Active NPI

William Wagner, CRNA

  • Certified Registered Nurse Anesthetist
  • Hillsborough, NC
National Provider Identifier
1558384875
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
109814 Issued in NC
Practice address
1710 Cheyenne Dr
Hillsborough, NC 27278-9500
Phone
(919) 619-4998
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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 109814 NC Primary

Addresses

Primary practice location

1710 Cheyenne Dr
Hillsborough, NC 27278-9500

Mailing address

1710 Cheyenne Dr
Hillsborough, NC 27278-9500
Phone (919) 619-4998

Other identifiers 1

IdentifierTypeStateIssuer
8050655MedicaidNC

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2016 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Nov 1, 2018 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2021 Accepting new patients
Durham Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
University of North Carolina at Chapel Hill Past Accepting new patients
Regional Anesthesia, PLLC Past Accepting new patients
Burlington Anesthesia PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1236 Huffman Mill Rd
Ste 2000
Burlington, NC 27215
Phone (336) 538-7180

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

4901 Dawn Dr
Ste 1100
Lumberton, NC 28360
Phone (910) 887-2361

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

1135 Carthage St
Sanford, NC 27330
Phone (910) 774-2100

Organizations & group practices 7

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1558384875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 CHEYENNE DR",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272789500",
            "telephone_number": "919-619-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 CHEYENNE DR",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272789500",
            "telephone_number": "919-619-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "109814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050655",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.