Individual provider Active NPI

Ethan Hazelrigs, BSN, MSN, CRNA

  • Certified Registered Nurse Anesthetist
  • Cary, NC
National Provider Identifier
1073917589
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
214369 Issued in NC
Practice address
500 Heathridge Lane
Cary, NC 27513
Phone
(919) 720-2723
NPI assigned
Oct 13, 2014
Last updated
Oct 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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 214369 NC Primary

Addresses

Primary practice location

500 Heathridge Lane
Cary, NC 27513

Mailing address

500 Heathridge Lane
Cary, NC 27513
Phone (919) 720-2723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150113001970 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587988928 Reassigns benefits to 4 organizations
I20190325002785 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587988928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
214369NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nash Hospitals Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 3, 2014 Accepting new patients
Granville Health System CurrentSince Dec 15, 2018 Accepting new patients
East Carolina Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 5, 2023 Accepting new patients
Nash Hospitals Inc CurrentSince Nov 3, 2014 Accepting new patients
Granville Health System Nurse Anesthetist, Certified Registered CurrentSince Dec 15, 2018 Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Mar 1, 2019 Accepting new patients
Regional Anesthesia, PLLC CurrentSince Feb 3, 2017 Accepting new patients

Locations

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

1010 College St
Oxford, NC 27565
Phone (919) 623-5115

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Organizations & group practices 8

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": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1073917589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HEATHRIDGE LANE",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-720-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HEATHRIDGE LANE",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-720-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELRIGS",
        "first_name": "ETHAN",
        "credential": "BSN, MSN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "214369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.