Individual provider Active NPI

Daniel B Willingham, CRNA

  • Certified Registered Nurse Anesthetist
  • High Point, NC
National Provider Identifier
1639704828
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
138480 Issued in NC
Practice address
401 Ferndale Blvd
High Point, NC 27262-4739
Phone
(336) 882-2567
Fax
(336) 882-5466
NPI assigned
Mar 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 278024 NC
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 138480 NC Primary

Addresses

Primary practice location

401 Ferndale Blvd
High Point, NC 27262-4739

Mailing address

5210 Switchback Dr
High Point, NC 27265-2934
Phone (336) 688-4917

Other practice location 1

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone (336) 688-4917

Other practice location 2

601 N Elm St
High Point, NC 27262-4331
Phone (336) 878-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004001754 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870979578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
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)

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734

Hospital & facility affiliations

  • High Point Regional Health System Hospital, High Point, NC, CCN 340004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
278024NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Anesthesiology, PA CurrentSince Oct 1, 2022 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2025 Accepting new patients

Locations

401 Ferndale Blvd
High Point, NC 27262
Phone (336) 882-2567

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 2

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.

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": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1639704828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 SWITCHBACK DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272652934",
            "telephone_number": "336-688-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 FERNDALE BLVD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624739",
            "telephone_number": "336-882-2567",
            "fax_number": "336-882-5466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Lake Boone Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077505",
            "country_code": "US",
            "telephone_number": "336-688-4917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 N Elm St",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272624331",
            "country_code": "US",
            "telephone_number": "336-878-6000",
            "fax_number": "336-878-6010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "DANIEL",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "278024",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "138480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.