Individual provider Active NPI

Marvin Bruce Pearson, CRNA

  • Certified Registered Nurse Anesthetist
  • Elizabeth City, NC
National Provider Identifier
1396831723
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1896 Issued in NC
Practice address
1144 N Road St
Elizabeth City, NC 27909-3353
Phone
(252) 335-0531
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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 1896 NC Primary

Addresses

Primary practice location

1144 N Road St
Elizabeth City, NC 27909-3353

Mailing address

1144 N Road St
Elizabeth City, NC 27909-3353
Phone (252) 335-0531

Other identifiers 1

IdentifierTypeStateIssuer
8052424MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000926 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698790582 Reassigns benefits to 15 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Brody School of Medicine at East Carolina University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-9073

2201 S Sterling St
Morganton, NC 28655-4044
Phone (828) 580-5000

301 Yadkin St
Albemarle, NC 28001-3441
Phone (980) 323-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1896NCMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Matthews Medical Center LLC CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Rowan Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Mint Hill Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Ballantyne Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
Morganton Anesthesia Partners, PLLC CurrentSince Apr 10, 2021 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Current Accepting new patients
Medical Park Hospital LLC CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Oct 10, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Brunswick Community Hospital, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Thomasville Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Morganton Anesthesia Partners, PLLC Current Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Current Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Current Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Oct 10, 2022 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2022 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Oct 10, 2022 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Medical Park Hospital LLC CurrentSince Oct 10, 2022 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Jan 1, 2019 Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

301 Yadkin St
Albemarle, NC 28001
Phone (704) 984-4000

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

14215 Ballantyne Corporate Pl
Ste 210
Charlotte, NC 28277
Phone (704) 316-2650

7210 Village Medical Cir
Ste 235
Clemmons, NC 27012
Phone (336) 893-3100

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1730 Kernersville Medical Pkwy
Ste 304
Kernersville, NC 27284
Phone (336) 515-7000

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 6

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1396831723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093353",
            "telephone_number": "252-335-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093353",
            "telephone_number": "252-335-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "MARVIN",
        "middle_name": "BRUCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "1896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052424",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.