Individual provider Active NPI

William Russell McNair, FNP

  • Family Nurse Practitioner
  • San Luis, AZ
National Provider Identifier
1780913236
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN160158 Issued in AZ
Practice address
1896 E. Babbit LN
San Luis, AZ 85349
Phone
(928) 627-9222
Fax
(928) 627-8315
NPI assigned
Dec 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN160158 AZ Primary

Addresses

Primary practice location

1896 E. Babbit LN
San Luis, AZ 85349

Mailing address

PO Box 617
Somerton, AZ 85350-0617
Phone (928) 662-0406

Other identifiers 2

IdentifierTypeStateIssuer
503006MedicaidAZ
Z137149OtherAZMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512001093 AZ Practitioner - Nurse Practitioner 5597893511 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Luis Walk-in Clinic IncGroup PAC ID 2668361841, 49 clinicians

Practice addresses (Care Compare)

1233 N Main St
Suite 1a
San Luis, AZ 85336-0663
Phone (928) 550-5514

214 W Main St
Somerton, AZ 85350-6329
Phone (928) 627-1120

950 E Main St
Somerton, AZ 85350-7409

Hospital & facility affiliations

  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN160158AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Walk-in Clinic, Inc. CurrentSince Feb 14, 2010 Accepting new patients
Regional Center for Border Health, Inc CurrentSince Sep 1, 2024 Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Feb 14, 2010 Accepting new patients
San Luis Walk-in Clinic, Inc. Current Accepting new patients

Locations

214 W Main St
Somerton, AZ 85350
Phone (928) 627-1120

1130 E Main St
Somerton, AZ 85350
Phone (928) 627-2017

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1780913236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-662-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 E. BABBIT LN",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "85349",
            "telephone_number": "928-627-9222",
            "fax_number": "928-627-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAIR",
        "first_name": "WILLIAM",
        "middle_name": "RUSSELL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-11",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN160158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503006",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z137149",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis, AZ

Sources for this page

Verify at the official NPI Registry.