Individual provider Active NPI

Richard E Wheeler, CRNA

  • Certified Registered Nurse Anesthetist
  • Lumberton, NC
National Provider Identifier
1629076732
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1019 Issued in SC
Practice address
300 W 27TH St
Lumberton, NC 28358-3075
Phone
(910) 671-5000
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 138634 NC
Certified Registered Nurse Anesthetist 367500000X 1019 SC Primary

Addresses

Primary practice location

300 W 27TH St
Lumberton, NC 28358-3075

Mailing address

300 W 27TH St
Attn: William J Gutekunst
Lumberton, NC 28358-3075
Phone (910) 671-5000

Other identifiers 2

IdentifierTypeStateIssuer
8051409MedicaidNC
AN0678MedicaidSC

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
138634NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Regional Medical Center Past Accepting new patients
Southeastern Regional Medical Center Past Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1629076732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "address_2": "ATTN: WILLIAM J GUTEKUNST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583075",
            "telephone_number": "910-671-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583075",
            "telephone_number": "910-671-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "RICHARD",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "138634",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "1019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051409",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0678",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.