Kevin A. Roark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

082168 Issued in NC

Practice address

2430 Emerald PL
Suite 201
Greenville, NC 27834-5784

Phone

(252) 752-2140

Fax

(252) 752-3949

NPI assigned

May 19, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Anesthesia Associates LLCGroup PAC ID 3274590856, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Western Anesthesia Associates LLC

  • Anesthesiology Physician
  • Bountiful, UT
  • NPI 1174566277
  Medicare reassignment Care Compare group NPD
• Mt Ogden Anesthesia Group LLC

  • Certified Registered Nurse Anesthetist
  • Ogden, UT
  • NPI 1770999807
  Medicare reassignment
• East Carolina Anesthesia Associates, PLLC

  • Anesthesiology Physician
  • Greenville, NC
  • NPI 1205996519

  Registered Nurse

  NPD (past)

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1366677403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL",
            "address_2": "SUITE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345784",
            "telephone_number": "252-752-2140",
            "fax_number": "252-752-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL",
            "address_2": "SUITE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345784",
            "telephone_number": "252-752-2140",
            "fax_number": "252-752-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROARK",
        "first_name": "KEVIN",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "082168",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "215024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00742958",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8053549",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Marie Rizer, QBA
• Areeba Hussain Rizvi, MD
• Richard Phillip Rizzuti, MD
• Chelsea Ann Roach, MD
• Tara Sandrea Roach, MSW,LCSW LCAS,CCSOTS
• Jeffrey W Robb, MD
• Adelaide Sarah Robbins, MD
• Almeta Roberson, LCSW-A
• Amelia Roberson
• Antionette Roberson, REGISTERED NURSE

• Certified Registered Nurse Anesthetist in Greenville, NC
• Providers in Greenville, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.