Individual provider Active NPI

Robert Shane Wilkins, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1801073424
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
181229 Issued in NC
Practice address
145 Kimel Park Dr
Suite 300
Winston Salem, NC 27103-6984
Phone
(336) 768-3212
NPI assigned
Jan 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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 181229 NC Primary

Addresses

Primary practice location

145 Kimel Park Dr
Suite 300
Winston Salem, NC 27103-6984

Mailing address

145 Kimel Park Dr
Suite 300
Winston Salem, NC 27103-6984
Phone (336) 768-3212

Other identifiers 2

IdentifierTypeStateIssuer
8053142MedicaidNC
NAN982MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080301000021 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911081864 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Services PAGroup PAC ID 7012937105, 54 clinicians

Practice addresses (Care Compare)

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 757-3636

2730 Georgia Rd
Franklin, NC 28734-7335
Phone (828) 349-3636

Merit-based Incentive Payment System (MIPS)

Final score
73.38 of 100Reported as group
Quality
77.5
Improvement activities
20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2323NCMDChiropractor
181229NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 23, 2022 Accepting new patients
LJP Anesthesia Services, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Western Carolina Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 23, 2022 Accepting new patients
Eagle Physicians and Associates PA Current Accepting new patients
Eagle Physicians and Associates PA CurrentSince Nov 15, 2019 Accepting new patients
East Carolina Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Nov 15, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients
Mercy Hospital, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Piedmont Triad Anesthesia, PA Nurse Anesthetist, Certified Registered PastSince Jul 20, 2004 Accepting new patients
CMC-Northeast, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Piedmont Community Physicians PC Past Accepting new patients

Locations

1002 N Church St
Ste 201
Greensboro, NC 27401
Phone (336) 378-0713

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

415 N Center St
Ste 300
Hickory, NC 28601
Phone (828) 328-3300

1580 Skeet Club Rd
High Point, NC 27265
Phone 336883002912268

507 N Lindsay St
High Point, NC 27262

137 Mount Calvary Rd
#A
Thomasville, NC 27360

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1801073424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-768-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-768-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "ROBERT",
        "middle_name": "SHANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-25",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "181229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8053142",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN982",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.