Individual provider Active NPI

William Dalling

  • Certified Registered Nurse Anesthetist
  • Fort Wayne, IN
National Provider Identifier
1619369154
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
163W00000X Issued in IN
Practice address
5734 Coventry LN
Fort Wayne, IN 46804-7141
Phone
(260) 435-7973
NPI assigned
Feb 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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 163W00000X IN Primary

Addresses

Primary practice location

5734 Coventry LN
Fort Wayne, IN 46804-7141

Mailing address

5734 Coventry LN
Fort Wayne, IN 46804-7141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170203002480 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193008860 Reassigns benefits to 1 organization
I20230614000890 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193008860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

601 W Leota St
North Platte, NE 69101-6525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
163W00000XINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Mountain View Hospital LLC CurrentSince Sep 1, 2021 Accepting new patients
Faith Regional Physician Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 19, 2023 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Jun 19, 2023 Accepting new patients
North Platte Nebraska Hospital Corporation CurrentSince Mar 1, 2025 Accepting new patients

Locations

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

2700 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 644-7131

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

Organizations & group practices 5

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 4

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": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1619369154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5734 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141",
            "telephone_number": "260-435-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLING",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "163W00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.