Individual provider Active NPI

Robert Gerald White Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Goldsboro, NC
National Provider Identifier
1154479541
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
183736 Issued in NC
Practice address
2700 Wayne Memorial Drive
Goldsboro, NC 27534
Phone
(919) 731-6068
Fax
(919) 731-6025
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 183736 NC Primary
Certified Registered Nurse Anesthetist 367500000X 76125 NC

Addresses

Primary practice location

2700 Wayne Memorial Drive
Goldsboro, NC 27534

Mailing address

2700 Wayne Memorial Drive
Goldsboro, NC 27534
Phone (919) 731-6068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000450 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810089513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne Memorial Hospital IncGroup PAC ID 3971409079, 29 clinicians

Practice addresses (Care Compare)

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone (919) 731-6142

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
183736NCMDCertified Registered Nurse Anesthetist
76125NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital Inc CurrentSince Oct 2, 2006 Accepting new patients
Wayne Memorial Hospital Inc CurrentSince Oct 2, 2006 Accepting new patients
Wayne Health Physicians Current Accepting new patients

Locations

2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060

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.

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154479541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DRIVE",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "27534",
            "telephone_number": "919-731-6068",
            "fax_number": "919-731-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DRIVE",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "27534",
            "telephone_number": "919-731-6068",
            "fax_number": "919-731-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ROBERT",
        "middle_name": "GERALD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "183736",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "76125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, 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.
  • 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.