Individual provider Active NPI

Wendy Williams, M.D.

  • Anesthesiology Physician
  • Scottsbluff, NE
National Provider Identifier
1609852904
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
26714 Issued in NE
Practice address
50020 Leisure LN
Scottsbluff, NE 69361-5520
Phone
(308) 672-8304
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 44162 CO
Anesthesiology Physician 207L00000X 26714 NE Primary

Addresses

Primary practice location

50020 Leisure LN
Scottsbluff, NE 69361-5520

Mailing address

50020 Leisure LN
Scottsbluff, NE 69361-5520
Phone (308) 672-8304

Other identifiers 2

IdentifierTypeStateIssuer
122047100MedicaidWY
54477786MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120807000698 NE Practitioner - Anesthesiology 6305850447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Colorado School of Medicine, Denver, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Nebraska LLCGroup PAC ID 2264857135, 21 clinicians

Practice addresses (Care Compare)

4021 Ave B
Scottsbluff, NE 69361-4602
Phone (214) 687-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44162COMDAnesthesiology Physician
26714NEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional West Medical Center Anesthesiology CurrentSince Jul 3, 2012 Accepting new patients
Northstar Anesthesia of Nebraska LLC Anesthesiology CurrentSince Jul 1, 2020 Accepting new patients
Regional West Medical Center CurrentSince Jul 3, 2012 Accepting new patients

Locations

4021 Avenue B
Scottsbluff, NE 69361
Phone (308) 630-1384

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1609852904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50020 LEISURE LN",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693615520",
            "telephone_number": "308-672-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50020 LEISURE LN",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693615520",
            "telephone_number": "308-672-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WENDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "44162",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "26714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122047100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54477786",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

Verify at the official NPI Registry.