Individual provider Active NPI

Gregory Shaun Wiggins, CRNA

  • Certified Registered Nurse Anesthetist
  • Fredericksburg, TX
National Provider Identifier
1851719025
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP125240 Issued in TX
Practice address
1020 S State Highway 16
Fredericksburg, TX 78624-4471
Phone
(830) 997-4353
NPI assigned
Apr 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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 AP125240 TX Primary

Addresses

Primary practice location

1020 S State Highway 16
Fredericksburg, TX 78624-4471

Mailing address

707 S Creek St
Apt. 215
Fredericksburg, TX 78624-5515
Phone (270) 226-9206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI, OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190118002164 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567687726 Reassigns benefits to 2 organizations
I20210309001685 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567687726 Reassigns benefits to 3 organizations
I20240426000123 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567687726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians
Monaco Management LLCGroup PAC ID 9739577461, 37 clinicians
Iceland Anesthesia Management LLCGroup PAC ID 7618372996, 75 clinicians

Practice addresses (Care Compare)

2001 Stults Rd
Huntington, IN 46750-1291
Phone (260) 355-3000

274 E Chicago St
Coldwater, MI 49036-2041
Phone (517) 279-5400

3663 N Country Dr
Alliance Surgery Ctr
Traverse City, MI 49684-4587
Phone (231) 252-1228

433 W High St
Bryan, OH 43506-1690
Phone (419) 636-1311

701 S Health Pkwy
Three Rivers Health Hospital
Three Rivers, MI 49093-8352
Phone (269) 278-1145

801 S Main St
Clinton, IN 47842-2261
Phone (765) 832-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP125240TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Branch County CurrentSince Apr 1, 2024 Accepting new patients
Community Health Center of Branch County Current Accepting new patients
Community Health Center of Branch County CurrentSince Apr 1, 2024 Accepting new patients
Clinical Colleagues Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 12, 2018 Accepting new patients
Regio T Penna MD, PC Current Accepting new patients
Monaco Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 20, 2025 Accepting new patients
Iceland Anesthesia Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 2, 2021 Accepting new patients
Community Health Center of Branch County Current Accepting new patients

Locations

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001

2001 Stults Rd
Huntington, IN 46750
Phone (219) 355-3000

207 N Townline Rd
Lagrange, IN 46761
Phone (260) 266-5300

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

1421 N 7th St
Terre Haute, IN 47807
Phone (812) 231-4604

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

3663 N Country Dr
Traverse City, MI 49684
Phone (231) 252-1228

9 Northeastern Blvd
Ste 400
Salem, NH 03079

121 Westfield Dr
Archbold, OH 43502
Phone (419) 445-2015

433 W High St
Bryan, OH 43506
Phone (419) 636-1131

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

Organizations & group practices 8

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 5

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1851719025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S CREEK ST",
            "address_2": "APT. 215",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245515",
            "telephone_number": "270-226-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S STATE HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244471",
            "telephone_number": "830-997-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "GREGORY",
        "middle_name": "SHAUN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP125240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.