Individual provider Active NPI

William Lundgren

  • Certified Registered Nurse Anesthetist
  • Daytona Beach, FL
National Provider Identifier
1992275572
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11001096 Issued in FL
Practice address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone
(386) 254-4000
NPI assigned
Nov 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11001096 FL Primary
Certified Registered Nurse Anesthetist 367500000X ARNP9245292 FL

Addresses

Primary practice location

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Mailing address

1329 SW 16TH St RM 2232
Gainesville, FL 32608-1128
Phone (352) 733-0485

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190307002343 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567701667 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11001096FLMDCertified Registered Nurse Anesthetist
ARNP9245292FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 20, 2020 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Sarasota Ambulatory Surgery Center LTD Current Accepting new patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 24, 2023 Accepting new patients
Space Coast Anesthesia Services LLC CurrentSince Jan 26, 2023 Accepting new patients
Orange City Anesthesia Services LLC CurrentSince May 15, 2023 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Jan 20, 2020 Accepting new patients
Sarasota Anesthesia Services LLC CurrentSince Jan 20, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Dec 11, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Dec 11, 2020 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

835 Currency Cir
Lake Mary, FL 32746
Phone (407) 544-6643

595 N Courtenay Pkwy
Ste 103
Merritt Island, FL 32953
Phone (321) 890-1800

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

975 Town Center Dr
Ste 100
Orange City, FL 32763
Phone (386) 456-5247

2863 Wellness Ave
Orange City, FL 32763
Phone (286) 297-7239

2821 Proctor Rd
Sarasota, FL 34231
Phone (941) 870-1872

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1992275572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 SW 16TH ST RM 2232",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081128",
            "telephone_number": "352-733-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-254-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-27",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11001096",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9245292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.