Individual provider Active NPI

Renetta J Gibson, CRNA

  • Certified Registered Nurse Anesthetist
  • Winter Park, FL
National Provider Identifier
1003171331
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9191470 Issued in FL
Practice address
2699 Lee Rd
Ste #510
Winter Park, FL 32789-1753
Phone
(407) 896-9500
NPI assigned
Jul 12, 2012
Last updated
Jul 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9191470 FL Primary

Addresses

Primary practice location

2699 Lee Rd
Ste #510
Winter Park, FL 32789-1753

Mailing address

2699 Lee Rd Ste 500
Winter Park, FL 32789-1742
Phone (407) 896-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120808000823 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648426544 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians
Office Anesthesia StaffingGroup PAC ID 6901285709, 62 clinicians
Ams National LLCGroup PAC ID 3870813025, 310 clinicians
West Florida Anesthesia Associates LLCGroup PAC ID 7517231186, 43 clinicians

Practice addresses (Care Compare)

110 N Lecanto Hwy
Lecanto, FL 34461-9190
Phone (352) 527-1825

2275 N Central Ave
Kissimmee, FL 34741-2342
Phone (727) 203-5114

2863 Wellness Ave
Orange City, FL 32763-8396
Phone (286) 297-7239

63 Barkley Cir
Suite 104
Fort Myers, FL 33907-4514
Phone (239) 275-8452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2023 Accepting new patients
Apollo Medical Group of Ocala LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 26, 2024 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 11, 2023 Accepting new patients
Innovative Medical Staffing Solutions Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2023 Accepting new patients
Sarasota Anesthesia Services LLC CurrentSince Jan 5, 2023 Accepting new patients
David W Nussear MD LLC CurrentSince Nov 27, 2023 Accepting new patients
Sarasota Ambulatory Surgery Center LTD Current Accepting new patients
West Florida Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2025 Accepting new patients
Office Anesthesia Staffing Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Orange City Anesthesia Services LLC CurrentSince Jan 5, 2023 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 322-5600

63 Barkley Cir
Ste 104
Fort Myers, FL 33907
Phone (239) 275-8452

1109 US Highway 19
Holiday, FL 34691
Phone (727) 934-5705

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

905 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 256-0933

460 Saint Charles Ct
Lake Mary, FL 32746
Phone (407) 585-0260

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

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

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

130 Tamiami Trl N
Ste 210
Naples, FL 34102
Phone (239) 434-8707

3241 SW 34th St
Ocala, FL 34474
Phone (352) 237-5906

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

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

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

6900 Turkey Lake Rd
Ste 2-5
Orlando, FL 32819
Phone (407) 354-5401

801 N Orange Ave
Ste 630
Orlando, FL 32801
Phone (407) 650-0051

1325 Belcher Rd
Palm Harbor, FL 34683
Phone (816) 500-0021

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFFIBD/Endpoint/DFFIBD

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1003171331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 LEE RD STE 500",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891742",
            "telephone_number": "407-896-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 LEE RD",
            "address_2": "STE #510",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891753",
            "telephone_number": "407-896-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RENETTA",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9191470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.