Individual provider Active NPI

Edna Mae Wilmoth, CRNA

  • Certified Registered Nurse Anesthetist
  • Hot Springs, AR
National Provider Identifier
1710914387
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 32179 / C00549 Issued in AR
Practice address
117 Drake LN
Hot Springs, AR 71913-7874
Phone
(501) 760-3200
Fax
(501) 760-5005
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R 32179 / C00549 AR Primary

Addresses

Primary practice location

117 Drake LN
Hot Springs, AR 71913-7874

Mailing address

117 Drake LN
Hot Springs, AR 71913-7874
Phone (501) 760-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 32179 / C00549ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Services LTD Past Accepting new patients
Mercy Tyler Hospital Past Accepting new patients
Jonesboro Anesthesia Inc Past Accepting new patients
Covenant Medical Center, Inc Past Accepting new patients
Mymichigan Medical Center Tawas Past Accepting new patients
Mercy Tyler Health Systems Past Accepting new patients
Metropolitan Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710914387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 DRAKE LN",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719137874",
            "telephone_number": "501-760-3200",
            "fax_number": "501-760-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 DRAKE LN",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719137874",
            "telephone_number": "501-760-3200",
            "fax_number": "501-760-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOTH",
        "first_name": "EDNA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R 32179 / C00549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.