Individual provider Active NPI

Robin C. Willoughby, CRNA

  • Certified Registered Nurse Anesthetist
  • Dover Foxcroft, ME
National Provider Identifier
1629220728
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA123056 Issued in ME
Practice address
897 W Main St
Dover Foxcroft, ME 04426-1029
Phone
(207) 564-8401
NPI assigned
Oct 21, 2008
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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 RNA123056 ME Primary

Addresses

Primary practice location

897 W Main St
Dover Foxcroft, ME 04426-1029

Mailing address

897 W Main St
Dover Foxcroft, ME 04426-1029
Phone (207) 564-8401

Other names 1

  • Robin C Degeorge Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140128000322 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406993666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MRH CorpGroup PAC ID 1355770892, 36 clinicians

Practice addresses (Care Compare)

897 W Main St
Dover Foxcroft, ME 04426-1029
Phone (207) 564-8401

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MRH Corp. CurrentSince Mar 1, 2020 Accepting new patients
Peconic Anesthesiologist, P.C. Past Accepting new patients

Locations

891 W Main St
Ste 200
Dovr Foxcroft, ME 04426
Phone (207) 564-4464

891 W Main St
Ste 500
Dovr Foxcroft, ME 04426
Phone (207) 564-4466

897 W Main St
Dovr Foxcroft, ME 04426
Phone (207) 564-4464

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.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1629220728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 W MAIN ST",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261029",
            "telephone_number": "207-564-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 W MAIN ST",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261029",
            "telephone_number": "207-564-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "ROBIN",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA123056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "DEGEORGE",
            "middle_name": "C",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dover Foxcroft, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.