RICKIE WILSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1417387119

RICKIE WILSON (CRNA) is a healthcare provider. based in Rockford, Illinois. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 209.010905 (IL). The NPI Number for RICKIE WILSON (CRNA) is 1417387119

Main info

Male
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
RICKIE WILSON (CRNA)
NPI
1417387119
Phone
(414) 702-0234
Address
1422 E STATE ST
Enumeration Date
15 November 2013
Last Update Date
15 November 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7087474000
Graduation Year
2003 (23 years ago)
PAC ID
5496988669
Group Practice PAC ID
4688893878
Professional Enrollment ID
I20140616000233
Address ID
IL604611010OL20201AVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

2,265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IL

Provider Addresses for RICKIE WILSON (CRNA)

  • 1422 E STATE ST

    APT # 5

    ROCKFORD, IL 611042338

    Phone: (414) 702-0234

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2023-05-11 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$16
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140616000233ICertified Registered Nurse Anesthetist (Crna)ILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope2020$0
00813Anesthesia for procedure on small and large bowel using an endoscope1616$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1313$0
View full utilization report →

Insurance plans in this area (ZIP 61104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688893878View full group profile
NameSpecialtyState
Anesthesiology, Pain ManagementWI
Certified Registered Nurse Anesthetist (Crna)MI
-IL
Certified Registered Nurse Anesthetist (Crna)NC
Certified Registered Nurse Anesthetist (Crna)WA
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)IL
A N E S T H E S I O L O G YIL
-IL
Anesthesiology, Interventional Pain Management, Pain ManagementIL

Reviews

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Frequently asked questions

What unique ID ties claims to RICKIE WILSON (CRNA)?
NPI 1417387119 is assigned to RICKIE WILSON (CRNA) under the national enumeration system.
Is RICKIE WILSON (CRNA) currently active in the NPI registry?
CMS-published data lists RICKIE WILSON (CRNA) as an active registrant.
What does RICKIE WILSON (CRNA) treat or focus on?
Patients typically see RICKIE WILSON (CRNA) under the specialty Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is RICKIE WILSON (CRNA)'s primary listing?
We display Rockford, Illinois because that is what the record indicates for RICKIE WILSON (CRNA).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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