Individual provider Active NPI

Bruce Edward Marshall, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1114933256
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
180941 Issued in NC
Practice address
145 Kimel Park Dr Ste 120
Winston Salem, NC 27103
Phone
(336) 768-3212
Fax
(336) 768-9019
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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 180941 NC Primary

Addresses

Primary practice location

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103

Mailing address

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6983
Phone (336) 768-3212

Other practice location 1

1706 Sand Dr
Uniontown, OH 44685-7836
Phone (330) 699-1035

Other practice location 2

1706 Sand Dr
Uniontown, OH 44685-7836
Phone (330) 699-1035

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BMARSHALL145185@DIRECT.NOVANTHEALTH.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070321000359 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173422128 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-8800

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180941NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Triad Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2006 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince May 22, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Mar 1, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Medical Park Hospital LLC CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Rowan Medical Center LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Novant Health Thomasville Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince May 22, 2020 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Medical Park Hospital LLC CurrentSince Mar 1, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC CurrentSince Mar 1, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC CurrentSince Mar 1, 2020 Accepting new patients
Rowan Regional Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Current Accepting new patients
Brunswick Community Hospital, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Mint Hill Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Associated Anesthesiologists of Toledo, Inc Past Accepting new patients
Perioperative Medical Consutants Inc Past Accepting new patients
Queen City Anesthesiologists Inc Past Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

14215 Ballantyne Corporate Pl
Ste 210
Charlotte, NC 28277
Phone (704) 316-2650

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

7210 Village Medical Cir
Ste 235
Clemmons, NC 27012
Phone (336) 893-3100

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1730 Kernersville Medical Pkwy
Ste 304
Kernersville, NC 27284
Phone (336) 515-7000

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

145 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-1770

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

Interoperability endpoints

  • Direct secure messaging: bmarshall145185@direct.novanthealth.org

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1114933256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036983",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1706 Sand Dr",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "OH",
            "postal_code": "446857836",
            "country_code": "US",
            "telephone_number": "330-699-1035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1706 Sand Dr",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "OH",
            "postal_code": "446857836",
            "country_code": "US",
            "telephone_number": "330-699-1035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "180941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BMARSHALL145185@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "1706 Sand Dr",
            "city": "Uniontown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446857836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.