Individual provider Active NPI

Woodrow Wilkie, CRNA

  • Certified Registered Nurse Anesthetist
  • Florence, SC
National Provider Identifier
1811957848
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN1113 Issued in SC
Practice address
555 Cheves Street
Florence, SC 29506-2617
Phone
(843) 777-8752
Fax
(843) 777-8705
NPI assigned
Mar 24, 2006
Last updated
Apr 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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 APN1113 SC Primary

Addresses

Primary practice location

555 Cheves Street
Florence, SC 29506-2617

Mailing address

PO Box 100551
Florence, SC 29501-0551
Phone (843) 777-8752

Other identifiers 1

IdentifierTypeStateIssuer
AN0056MedicaidSC

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22952SCMDFamily Nurse Practitioner
APN1113SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

701 Cashua Ferry Rd
Darlington, SC 29532
Phone (843) 395-1100

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1811957848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100551",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295010551",
            "telephone_number": "843-777-8752",
            "fax_number": "843-777-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CHEVES STREET",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062617",
            "telephone_number": "843-777-8752",
            "fax_number": "843-777-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIE",
        "first_name": "WOODROW",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "APN1113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0056",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.