Lucas Willoughby, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

19279 Issued in SC

Practice address

9263 Medical Plaza Dr
Ste E
Charleston, SC 29406-7112

Phone

(843) 572-1228

Fax

(843) 576-6168

NPI assigned

Dec 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Medical University of South Carolina College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Gastroenterology SpecialistsGroup PAC ID 3173437472, 49 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

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.

• Charleston Gastroenterology Specialists

  • Specialist
  • Charleston, SC
  • NPI 1205835865
  Medicare reassignment Care Compare group NPD
• Charleston Gastroenterology Specialists

  • Anesthesiology Physician
  • Charleston, SC
  • NPI 1194231761
  NPD
• Mobile Anesthesia, LLC

  • Anesthesiology Physician
  • Charleston, SC
  • NPI 1992943484
  NPD (past)

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1669870929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR",
            "address_2": "STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228",
            "fax_number": "843-576-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR",
            "address_2": "STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228",
            "fax_number": "843-576-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "LUCAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-18",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "106598",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "19279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edith Barrett Willis, PA-C
• Lindsey Dill Willis, MSN, FNP-BC
• Virginia A Willis, RPH
• Lisa Willmuth, CCC
• Ira R Willner, MD
• Michael L Willoughby, M.D.
• Lauren Wilseck
• Alison Wilson, CCC-SLP
• Bethany M Wilson, LMT
• Brittany E Wilson, DO

• Certified Registered Nurse Anesthetist in Charleston, SC
• Providers in Charleston, SC by specialty
• Certified Registered Nurse Anesthetist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.