Charles Derrick Wilson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN065069 Issued in GA

Practice address

4800 48TH St
Valley, AL 36854-3666

Phone

(334) 756-1848

Fax

(334) 756-1854

NPI assigned

Apr 27, 2006

Last updated

Sep 27, 2011By the provider in NPPES

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AL, GA, NC, KS4 enrollments

Enrollment records 4

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians

US Anesthesia Partners of Kansas PAGroup PAC ID 7719245299, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Catherine Hospital - Garden City Hospital, Garden City, KS, CCN 170023
• Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

Merit-based Incentive Payment System (MIPS)

Final score

73.38 of 100Reported as group

Quality

77.5

Improvement activities

20

Merit-based Incentive Payment System (MIPS)

Final score

82.33 of 100Reported as group

Quality

78.32

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 29)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  Medicare reassignment Care Compare group NPD
• US Anesthesia Partners of Kansas PA

  • Anesthesiology Physician
  • Greenwood Village, CO
  • NPI 1811415599

  KS, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Wilson Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
  • NPI 1104178482

  AL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• Huntsville Hospital Anesthesia

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
  • NPI 1851321079

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Montgomery Anesthesia Associates, PC

  • Anesthesiology Physician
  • Montgomery, AL
  • NPI 1043281553

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ambulatory Anesthesia Partners LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1851799373

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Amsol Anesthetists of Georgia, LLC

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
  • NPI 1649224775

  AL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Care Services, PA

  • Certified Registered Nurse Anesthetist
  • Forest, VA
  • NPI 1609833474

  GA, NC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Grady Memorial Hospital Corporation

  dba Grady Health System

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment NPD
• RG Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Rome, GA
  • NPI 1235553421

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• St. Francis Physician Practices LLC

  dba St. Francis Primary Care

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1326749417
  Medicare reassignment NPD
• Union County Hospital Authority

  dba Union General Hospital

  • General Acute Care Hospital
  • Blairsville, GA
  • NPI 1487684122
  Medicare reassignment NPD

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

• Commonspirit Kansas, Inc.

  dba St. Catherine Hospital - Garden City

  • General Acute Care Hospital
  • Garden City, KS
  • NPI 1659360196
  Care Compare affiliation
• West Georgia Medical Center, Inc.

  dba WellStar West Georgia Medical Center

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1730146309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661495",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352661495",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 48TH ST",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368543666",
            "telephone_number": "334-756-1848",
            "fax_number": "334-756-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "DERRICK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-044011",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN065069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000549381C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000549381D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051517977",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL PROVIDER #",
            "identifier": "51517977",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000549381E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashton Scott Vega, PHARMD
• Vision World Inc
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0733)
• Wal-Mart Stores East, LP (Vision Center 30-0733)
• Jennifer Williams
• Women's Health at Water's Edge
• Wood Family Eyecare OD LLC (Wood Family Eyecare)
• Audrey Brazeal Wood, O.D.

• Certified Registered Nurse Anesthetist in Valley, AL
• Providers in Valley, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.