Annie Delores Blackwell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

072294 Issued in NC

Practice address

117 E Kings Hwy
Eden, NC 27288-5201

Phone

(336) 623-9711

NPI assigned

Jan 25, 2007

Last updated

Sep 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Annie Delores Manning Other name

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment Care Compare group NPD
• American Anesthesiology of North Carolina, PLLC

  • Certified Registered Nurse Anesthetist
  • Burlington, NC
  • NPI 1053677195

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• American Anesthesiology of Virginia PC

  • Anesthesiology Physician
  • Falls Church, VA
  • NPI 1417994872
  Medicare reassignment NPD
• American Anesthesiology of North Carolina, PLLC

  dba Carolina Pain Consultants

  • Pain Medicine (Anesthesiology) Physician
  • Wake Forest, NC
  • NPI 1942248547

  Nurse Anesthetist, Certified Registered

  NPD
• American Anesthesiology of Virginia, PC

  • Anesthesiology Physician
  • Leesburg, VA
  • NPI 1053675199
  NPD
• Lexington Medical Center

  • General Acute Care Hospital
  • Lexington, NC
  • NPI 1417958331
  NPD (past)
• Piedmont Triad Anesthesia, PA

  • Anesthesiology Physician
  • Winston Salem, NC
  • NPI 1467497081

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Danville Anesthesiologists Inc

  • Anesthesiology Physician
  • Danville, VA
  • NPI 1184700569
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Carolina Baptist Hospital

  • Psychiatric Hospital Unit
  • Winston Salem, NC
  • NPI 1063480531
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1114995677
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1144211301
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1609162098

  Hospital

  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Winston East Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Winston Salem, NC
  • NPI 1912179219

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1598811663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ANNIE",
        "middle_name": "DELORES",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "072294",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024165671",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051039",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "MANNING",
            "middle_name": "DELORES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clarence Henry Beavers, M.D.
• Birds Song of North Carolina
• Ashya Black
• Body & Face LLC
• Alyssa Horton Boles, PA-C
• Angela Renee Boone, NP ADULT GERIATRIC
• Logan Hunter Boothe, NRP
• Boulevard Pharmacy Inc

• Certified Registered Nurse Anesthetist in Eden, NC
• Providers in Eden, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.