Gary D Rodewald, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN22190 Issued in MT

Practice address

1200 Westwood Dr
Hamilton, MT 59840-2345

Phone

(406) 363-2211

Fax

(406) 375-4590

NPI assigned

May 20, 2006

Last updated

Nov 5, 2015By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1255385787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WESTWOOD DR",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402345",
            "telephone_number": "406-363-2211",
            "fax_number": "406-375-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WESTWOOD DR",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402345",
            "telephone_number": "406-363-2211",
            "fax_number": "406-375-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEWALD",
        "first_name": "GARY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "RN22190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "M000009917",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255385787",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255385787",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roberts Family Chiropractic Center Inc. (DMX Imaging of Montana)
• Kathy K Roberts-Green, RN
• Elizabeth Lee Roberts, DC
• Gilbert James Roberts, DC
• Rocky Mountain Optical & Contact Lens Center, Inc.
• Daniel Rogers
• Roots & Blossoms Counseling LLC
• Rosewood Wellness Center & Spa,LLC
• Pamela June Russell
• William Salterberg

• Certified Registered Nurse Anesthetist in Hamilton, MT
• Providers in Hamilton, MT by specialty
• Certified Registered Nurse Anesthetist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.