Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Michael Wildy, CRNA

Individual provider Registered Nurse · NPI 1619137288

Jonathan Michael Wildy, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Prairie Village, Kansas. Qualified in 2009, 17 years ago. Practices with Pine Ridge Indian Health Service Hospital, a 104-clinician group and accepts Medicare assignment. Licensed in California, Kansas and Virginia.

Years since qualifying
17
Licensed in
CA, KS, VA
In the registry since
2008
Specialties on file
5
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

5101 W 73rd St
Prairie Village, KS 66208-2434
Phone: (619) 600-1023
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 3906 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 1390081012 (KS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (CA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 0024168911 (VA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 556930 (KS)

Record details

NPI number1619137288
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedJune 16, 2008
Last updated in NPPESOctober 18, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Pine Ridge Indian Health Service Hospital — 104 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Prairie Village