Roger Dean Gates, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

055985 Issued in NC

Practice address

3018 W Pelican Dr
Oak Island, NC 28465-7743

Phone

(910) 278-9365

Fax

(910) 278-1288

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114093614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 W PELICAN DR",
            "city": "OAK ISLAND",
            "state": "NC",
            "postal_code": "284657743",
            "telephone_number": "910-278-9365",
            "fax_number": "910-278-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 W PELICAN DR",
            "city": "OAK ISLAND",
            "state": "NC",
            "postal_code": "284657743",
            "telephone_number": "910-278-9365",
            "fax_number": "910-278-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "ROGER",
        "middle_name": "DEAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "055985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Cook
• Cristan Lee Crider, APRN, MSN-FNP-C
• Jeffrey H Ezzelle, RPH
• Karen A Fairfield, DC
• Sidney Ray Fortney, MD
• Lorraine Marie Gauthier, MD
• Heather Lyles Goldfuss, PA-C
• Virginia I Gorman, LCAS
• Darren W Harrington, D.D.S.
• Patricia Jean Hawkins, COTA/L

• Certified Registered Nurse Anesthetist in Oak Island, NC
• Providers in Oak Island, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• 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.

Verify at the official NPI Registry.