Wifredo Gonzalez, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

00035342 Issued in NC

Practice address

288 S. Ridgecrest Avenue
Rutherfordton, NC 28139

Phone

(828) 286-5420

Fax

(706) 731-5289

NPI assigned

Sep 5, 2006

Last updated

Jun 21, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rutherford Anesthesiology Associates, LLP

  • Anesthesiology Physician
  • Rutherfordton, NC
  • NPI 1194833855
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1386746618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3864",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143864",
            "telephone_number": "706-737-4575",
            "fax_number": "706-731-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 S. RIDGECREST AVENUE",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "28139",
            "telephone_number": "828-286-5420",
            "fax_number": "706-731-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "WIFREDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "00035342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5781203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - RUTHERFORD ANESTH",
            "identifier": "1194833855",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "83095",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1036209",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8936179",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "36179",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genesis Rehab Services
• Todd L Gilliam
• Jason Phillip Glover, DPM
• Abigail F Gonzales, PT
• Shannon Gonzalez, MA, NCC, LPCA
• Gregory Blake Goode, MD
• Jessica Nicole Goode, LPC-A
• Cassandra Marie Graeff, MD
• Lindsey Morgan Grant, PHARM.D.
• Ray Grant, PT

• Anesthesiology Physician in Rutherfordton, NC
• Providers in Rutherfordton, NC by specialty
• Anesthesiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.