Mark E Wilson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3110304406 Issued in UT

Practice address

2055 N Main St
Tooele, UT 84074-9819

Phone

(435) 843-3600

NPI assigned

Jul 27, 2006

Last updated

Dec 7, 2009By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Anesthesia Services LLCGroup PAC ID 5890927404, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1583/brand/2/csg/28/fhir/r4

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.

• Pinnacle Anesthesia Services LLC

  • Specialist
  • Rock Springs, WY
  • NPI 1588092274
  Medicare reassignment Care Compare group NPD
• Campbell County Hospital District

  dba Campbell County Medical Group - Internal Medicine Clinic

  • Internal Medicine Physician
  • Gillette, WY
  • NPI 1710098868
  Medicare reassignment NPD
• Evanston Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Evanston, WY
  • NPI 1891979258

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Evanston Hospital Corporation

  • Certified Registered Nurse Anesthetist
  • Evanston, WY
  • NPI 1013288836

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Medicare reassignment NPD
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  Medicare reassignment NPD
• Campbell County Hospital District

  dba Camp County Memorial Hospital - Physician Group

  • Emergency Medicine Physician
  • Gillette, WY
  • NPI 1063575611
  NPD
• Campbell County Hospital District

  dba Behavioral Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gillette, WY
  • NPI 1881730141
  NPD
• Campbell County Hospital District

  dba Campbell County Health

  • Community/Retail Pharmacy
  • Gillette, WY
  • NPI 1992874218
  NPD
• Evanston Hospital Corporation

  dba Evanston Regional Hospital

  • General Acute Care Hospital
  • Evanston, WY
  • NPI 1639140015
  NPD
• American Anesthesiology of Minnesota, P.a.

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1588669840

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1881608800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9895 EDEN CREST RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953011",
            "telephone_number": "801-254-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749819",
            "telephone_number": "435-843-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "3110304406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000061222",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailee Willard, CSW
• Adam Willis, PT, DPT
• Willow Creek Hospice of Utah, LLC (Pine Mountain Hospice)
• Willow Springs Counseling,LLC.
• Ashley Christine Wilson
• Valerie Wilson
• Edwin C Winder III, OD
• Leticia Guadalupe Winn
• Stephanie Winter
• Joshua Ty Winters

• Certified Registered Nurse Anesthetist in Tooele, UT
• Providers in Tooele, UT by specialty
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.