Individual provider Active NPI

Gregory Rabalais, CRNA

  • Certified Registered Nurse Anesthetist
  • Crossett, AR
National Provider Identifier
1497710776
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R63088 Issued in AR
Practice address
1015 Unity Rd
Hwy 82E
Crossett, AR 71635-9443
Phone
(870) 364-1280
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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 R63088 AR Primary

Addresses

Primary practice location

1015 Unity Rd
Hwy 82E
Crossett, AR 71635-9443

Mailing address

400 E 10TH St
Waconia, MN 55387-4552
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
136838701MedicaidAR
5U361OtherARBLUE CROSS OF AR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100105000058 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820139413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossett Health FoundationGroup PAC ID 9133030117, 23 clinicians

Practice addresses (Care Compare)

1015 Unity Rd
Crossett, AR 71635-9443
Phone (870) 364-1439

Hospital & facility affiliations

  • Ashley County Medical Center Hospital, Crossett, AR, CCN 041323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R63088ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Crossett Health Foundation Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2001 Accepting new patients
Crossett Health Foundation CurrentSince Sep 1, 2001 Accepting new patients
Crossett Health Foundation Past Accepting new patients
Twin City Anesthesia Past Accepting new patients
Crossett Health Foundation Past Accepting new patients
Crossett Health Foundation Past Accepting new patients

Locations

1015 Unity Rd
#400
Crossett, AR 71635
Phone (870) 364-1272

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

400 10th St E
Waconia, MN 55387

Organizations & group practices 6

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1497710776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 UNITY RD",
            "address_2": "HWY 82E",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716359443",
            "telephone_number": "870-364-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABALAIS",
        "first_name": "GREGORY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R63088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136838701",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AR",
            "identifier": "5U361",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossett, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.