WILLIAM III WYNN – Certified Registered Nurse Anesthetist, NPI 1164431805

WILLIAM III WYNN is a healthcare provider. based in Springfield, Missouri. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 143555 (MO). The NPI Number for WILLIAM III WYNN is 1164431805

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
WILLIAM III WYNN
NPI
1164431805
Phone
(417) 269-4550
Address
1000 E PRIMROSE ST STE 520
Enumeration Date
5 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4172696000
Graduation Year
2000 (26 years ago)
PAC ID
9234188541
Group Practice PAC ID
1850290149
Professional Enrollment ID
I20050113000539
Address ID
MO658075210SP3801XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO

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Provider Addresses for WILLIAM III WYNN

  • 520, East Primrose Street, Springfield, Greene County, Missouri, 65807, United States

    SPRINGFIELD, MO 658075180

    Phone: (417) 269-4550

    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 3 Open Payments records for all available years, with a total value of $60.

Total Amount is formed as General ($60) + Research ($0) + Ownership ($0) = $60.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($40).

Total Amount

$60

General + Research + Ownership

Payments

3

Total payment records

General Amount

$60

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2005-01-13

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
I20050113000539ICertified Registered Nurse Anesthetist (Crna)MOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65807)

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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: 1850290149View full group profile
NameSpecialtyState
Anesthesiology AssistantMO
Certified Registered Nurse Anesthetist (Crna)MO
-MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
A N E S T H E S I O L O G YMO
Certified Registered Nurse Anesthetist (Crna)MO
Anesthesiology AssistantMO
Anesthesiology AssistantMO
-MO

Reviews

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Frequently asked questions

Where can patients find WILLIAM III WYNN's NPI?
You can confirm WILLIAM III WYNN with NPI 1164431805; it appears in the national provider directory.
Is WILLIAM III WYNN's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does WILLIAM III WYNN work in?
You can think of WILLIAM III WYNN as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Does WILLIAM III WYNN practice in Missouri?
You will see Springfield, Missouri on file for WILLIAM III WYNN alongside any extra practice locations.
Is WILLIAM III WYNN a real provider?
This page reflects official NPPES data for NPI 1164431805. Always confirm identity and privileges with the practice and licensing boards.

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