Active NPI
Michelle L Gudelski, CRNA
- Certified Registered Nurse Anesthetist
- Lexington, SC
National Provider Identifier
1225046048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 24165492
- Practice address
- 304 Mooring LN
Lexington, SC 29072-9633 - Phone
- (757) 332-9024
- NPI assigned
- Aug 4, 2006
- Sex
- Female
- 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 | 24165492 | VA | Primary |
Addresses
Primary practice location
304 Mooring LN
Lexington, SC 29072-9633
Mailing address
304 Mooring LN
Lexington, SC 29072-9633
Phone (757) 332-9024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008950369 | Medicaid | VA |
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
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3049 | SC | MD | Occupational Therapy Assistant |
| 24165492 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jay Godines, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Turlock Anesthesia Medical Group Inc | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesia Associates of Savannah ,PA | 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.
-
- Anesthesiology Physician
- Sumter, SC
- NPI 1831498559
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Savannah, GA
- NPI 1487663688
-
- Anesthesiology Physician
- Turlock, CA
- NPI 1275835605
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307664000000",
"number": "1225046048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 MOORING LN",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290729633",
"telephone_number": "757-332-9024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 MOORING LN",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290729633",
"telephone_number": "757-332-9024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUDELSKI",
"first_name": "MICHELLE",
"middle_name": "L",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2011-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "24165492",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008950369",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.