Individual provider Active NPI

Judith Daniels Sanders, CRNA

  • Certified Registered Nurse Anesthetist
  • Goldsboro, NC
National Provider Identifier
1417225665
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
186930 Issued in NC
Practice address
2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone
(919) 731-6068
Fax
(919) 731-6025
NPI assigned
Dec 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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 186930 NC Primary

Addresses

Primary practice location

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494

Mailing address

410 Cardinal Dr
Goldsboro, NC 27534-1806
Phone (919) 736-3506

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000006 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769658095 Reassigns benefits to 1 organization

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
Wayne Memorial Hospital IncGroup PAC ID 3971409079, 29 clinicians

Practice addresses (Care Compare)

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone (919) 736-1110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
186930NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital Inc CurrentSince Nov 21, 2011 Accepting new patients
Wayne Memorial Hospital Inc CurrentSince Nov 21, 2011 Accepting new patients
Raleigh Medical Group, PA CurrentSince Jan 27, 2024 Accepting new patients

Locations

2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060

3521 Haworth Dr
Raleigh, NC 27609
Phone (919) 782-1806

2601 Lake Dr
Ste 201
Raleigh, NC 27607
Phone (919) 783-4888

2402 Camden St SW
Ste 300
Wilson, NC 27893
Phone (252) 237-4100

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1417225665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CARDINAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275341806",
            "telephone_number": "919-736-3506",
            "fax_number": "919-731-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349494",
            "telephone_number": "919-731-6068",
            "fax_number": "919-731-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JUDITH",
        "middle_name": "DANIELS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "186930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.