Active NPI
Dale Davis, CRNA
- Certified Registered Nurse Anesthetist
- Shelby, NC
National Provider Identifier
1043300957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 047567
- Practice address
- 201 E Grover St
Shelby, NC 28150-3917 - Phone
- (704) 487-3000
- Fax
- (704) 476-7417
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 047567 | NC | Primary |
Addresses
Primary practice location
201 E Grover St
Shelby, NC 28150-3917
Mailing address
201 E Grover St
Shelby, NC 28150-3917
Phone (704) 487-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47567 | NC | MD | Psychiatry Physician |
| 047567 | NC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gaston Cardiac Anesthesis and | Past | Accepting new patients | |
| Gaston Anesthesia Associates, P.a. | Past | Accepting new patients | |
| Gaston Cardiac Anethesis and | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Gastonia, NC
- NPI 1629024062
-
- Anesthesiology Physician
- Gastonia, NC
- NPI 1316994163
-
- Certified Registered Nurse Anesthetist
- Gastonia, NC
- NPI 1598890733
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043300957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E GROVER ST",
"city": "SHELBY",
"state": "NC",
"postal_code": "281503917",
"telephone_number": "704-487-3000",
"fax_number": "704-476-7417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E GROVER ST",
"city": "SHELBY",
"state": "NC",
"postal_code": "281503917",
"telephone_number": "704-487-3000",
"fax_number": "704-476-7417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DALE",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "047567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shelby, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.