Regenia L. Wilson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RNA109 Issued in ID

Practice address

1000 State St
McCall, ID 83638-3704

Phone

(208) 634-2221

Fax

(208) 634-7112

NPI assigned

Aug 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Orthopedic Ambulatory Anesthesia PA

  • Anesthesiology Physician
  • Boise, ID
  • NPI 1114119955
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891707360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4283 N NINES RIDGE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837021866",
            "telephone_number": "208-345-5830",
            "fax_number": "208-345-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 STATE ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836383704",
            "telephone_number": "208-634-2221",
            "fax_number": "208-634-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "REGENIA",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP #",
            "identifier": "89250",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "000010017281",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "A4092",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Weller, M.D.
• Julie L. Welty, MD
• Sara Wenig
• Richard David Wildman, DMD
• Joseph Carroll Wilson, M.S.W.,L.C.S.W.
• Marcia L. Witte, MD
• Patty H Wold, LMSW
• Heidi Jo Wyman, DPT, OCS
• Debra Anne Yaritz I, D.C.
• Debra Ann Jones Yensen, ATR, LCPC

• Certified Registered Nurse Anesthetist in McCall, ID
• Providers in McCall, ID by specialty
• Certified Registered Nurse Anesthetist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.