Charlie K. Wilson Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

557391 Issued in KS

Practice address

800 Raven Hill Drive
Atchison, KS 66002

Phone

(913) 367-2131

Fax

(913) 674-2023

NPI assigned

Jul 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Memorial Hospital DistrictGroup PAC ID 2769574433, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Citizens Memorial Hospital District

  • Emergency Medicine Physician
  • Bolivar, MO
  • NPI 1558548818

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Citizens Memorial Hospital District

  • Community/Retail Pharmacy
  • Buffalo, MO
  • NPI 1427480995
  NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD

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

• Citizens Memorial Hospital District

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1649688656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 RAVEN HILL DRIVE",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "66002",
            "telephone_number": "913-367-2131",
            "fax_number": "913-674-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RAVEN HILL DRIVE",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "66002",
            "telephone_number": "913-367-2131",
            "fax_number": "913-674-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLIE",
        "middle_name": "K.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "557391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2014014788",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen William Wheatley, D.C.
• Lisa Ann Whitfield, FNP-C
• Cindy D. Whitmer, M.A., L.P.C.
• Patricia Wick
• Jade Williams
• Jonathan Robert Wingate, DDS
• Marjorie H Wolter, D.D.S., F.A.G.D.
• Pekkei Wong, PHARMD
• Lane Tyler Young, CRNA
• Lauren Zule, PHARMD

• Certified Registered Nurse Anesthetist in Atchison, KS
• Providers in Atchison, KS by specialty
• Certified Registered Nurse Anesthetist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.