ERVIN WILLIAMS CRNA, NPI 1699145417 — FORT MYERS (FL)

NPI 1699145417

4+ Years Experience Individual

ERVIN WILLIAMS CRNA

10.06.2015
PROVIDER ENUMERATION DATE
10.06.2015
LAST UPDATE DATE
1699145417
NPI NUMBER

About ERVIN WILLIAMS

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

ERVIN WILLIAMS is a provider established in FORT MYERS, FL. The NPI number of ERVIN WILLIAMS is 1699145417 and was assigned on 10.06.2015. The practitioners primary taxonomy code is: 367H00000X with license number: AA289 FL .

Mailing address

  • City: FORT MYERS
  • State: FL
  • Postal code: 339019322
  • Phone: 2393325344
  • Fax: 2393327246
  • Address: 4048 EVANS AVE
  • Address 2: STE 303

Primary Practice Address

  • Region : FORT MYERS, FL
  • NPI : 1699145417
  • Phone : 2393325344
  • Fax : 2393327246
  • Postalcode : 339019322
  • Address : 4048 EVANS AVE STE 303

Provider taxonomy - Anesthesiologist Assistant

  • Taxonomy code: 367H00000X
  • License number: AA289
  • License state: FL

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor"s degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

Contacts:

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  • ERVIN WILLIAMS CRNA
  • Address : 4048 EVANS AVE STE 303
  • Region : FORT MYERS, FL
  • NPI : 1699145417
  • Phone : 2393325344
  • Fax : 2393327246
  • Postalcode : 339019322

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address4048 EVANS AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSTE 303
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameFORT MYERS
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameFL
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code339019322
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2393325344
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2393327246
The fax number associated with the location address of the provider being identified.
NPI1699145417
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1367H00000X
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor"s degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
Provider Enumeration Date10.06.2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10.06.2015
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)ERVIN WILLIAMS
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address4048 EVANS AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSTE 303
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameFORT MYERS
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameFL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code339019322
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2393325344
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number2393327246
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1367H00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Anesthesiologist Assistant
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor"s degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
Provider License Number 1AA289
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1FL
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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