Individual provider Active NPI

Christopher Gatheral, CRNA

  • Certified Registered Nurse Anesthetist
  • Orange Park, FL
National Provider Identifier
1316219231
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9226246 Issued in FL
Practice address
2021 Kingsley Ave
Suite 105
Orange Park, FL 32073-5174
Phone
(904) 276-5400
Fax
(904) 276-5430
NPI assigned
Feb 8, 2012
Last updated
Jul 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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 9226246 FL Primary

Addresses

Primary practice location

2021 Kingsley Ave
Suite 105
Orange Park, FL 32073-5174

Mailing address

2021 Kingsley Ave
Suite 105
Orange Park, FL 32073-5174
Phone (904) 276-5400

Other identifiers 1

IdentifierTypeStateIssuer
004773300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170714001501 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860652336 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ad of South Carolina LLCGroup PAC ID 6901269224, 28 clinicians

Practice addresses (Care Compare)

302 University Pkwy
Aiken, SC 29801-6302
Phone (888) 851-4642

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9226246FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Regional Medical Centers Nurse Anesthetist, Certified Registered CurrentSince Apr 24, 2017 Accepting new patients
Ad of South Carolina LLC CurrentSince Aug 13, 2023 Accepting new patients
Aiken Regional Medical Centers LLC Current Accepting new patients
Aiken Regional Medical Centers LLC CurrentSince Apr 24, 2017 Accepting new patients
Atlantic Coast Anesthesia Services P.C. Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2022 Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1316219231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 KINGSLEY AVE",
            "address_2": "SUITE 105",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735174",
            "telephone_number": "904-276-5400",
            "fax_number": "904-276-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 KINGSLEY AVE",
            "address_2": "SUITE 105",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735174",
            "telephone_number": "904-276-5400",
            "fax_number": "904-276-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATHERAL",
        "first_name": "CHRISTOPHER",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9226246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004773300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.