NPIMap

Organization Active NPI

Nurse Anesthetist Professionals Inc

  • Anesthesiology Physician
  • Conway, AR
National Provider Identifier
1689661696
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NURSE ANESTHETIST PROFESSIONALS INC
Practice address
1101 Museum Rd Ste 5
Conway, AR 72032-8580
Phone
(501) 771-4370
Fax
(501) 327-9722
NPI assigned
Oct 4, 2005
Last updated
Mar 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Bob Wilimzig, CRNA
Title
President
Phone
(501) 771-4370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

1101 Museum Rd Ste 5
Conway, AR 72032-8580

Mailing address

PO Box 16474
Little Rock, AR 72231-6474
Phone (501) 771-4370

Other identifiers 3

IdentifierTypeStateIssuer
CJ9207OtherARPALMETTO RAILROAD MEDICAR
5C548OtherARBLUE CROSS BLUE SHIELD
146556002MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000324 AR Part B Supplier - Clinic/Group Practice 5890680714 Receives reassigned benefits from 17 practitioners
Practice locations: Benton, AR; Little Rock, AR; North Little Rock, AR

National Provider Directory

National Provider Directory

Locations

5 Medical Park Dr
Ste 206
Benton, AR 72015
Phone (501) 227-5885

1101 Museum Rd
Ste 5
Conway, AR 72032

1508 Macon Dr
Ste C6
Little Rock, AR 72211
Phone (501) 224-7246

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1689661696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16474",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722316474",
            "telephone_number": "501-771-4370",
            "fax_number": "501-327-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MUSEUM RD STE 5",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720328580",
            "telephone_number": "501-771-4370",
            "fax_number": "501-327-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE ANESTHETIST PROFESSIONALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "WILIMZIG",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-771-4370",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RAILROAD MEDICAR",
            "identifier": "CJ9207",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C548",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146556002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.