NPIMap

Individual provider Active NPI

Glenn P Thomasson, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, NC
National Provider Identifier
1497805287
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
073405 Issued in NC
Practice address
2430 Emerald PL
Suite 201
Greenville, NC 27834-5784
Phone
(252) 752-2140
Fax
(252) 752-3949
NPI assigned
Jan 12, 2007
Last updated
Jun 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 073405 NC Primary
Registered Nurse 163W00000X 118027 NC

Addresses

Primary practice location

2430 Emerald PL
Suite 201
Greenville, NC 27834-5784

Mailing address

2430 Emerald PL
Suite 201
Greenville, NC 27834-5784
Phone (252) 752-2140

Other identifiers 2

IdentifierTypeStateIssuer
8052825MedicaidNC
P00601428OtherNCRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070521000022 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880791292 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
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)

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-7392

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone (919) 731-6142

607 Beaman St
Clinton, NC 28328-2603
Phone (910) 592-8511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073405NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital Inc CurrentSince Dec 26, 2023 Accepting new patients
Wayne Health Physicians Current Accepting new patients
Cumberland County Hospital System Inc CurrentSince Dec 18, 2015 Accepting new patients
Bladen Healthcare LLC CurrentSince Aug 25, 2013 Accepting new patients
Sampson Regional Medical Services, LLC Current Accepting new patients
Onslow Memorial Hospital Inc CurrentSince Mar 4, 2013 Accepting new patients
Onslow Memorial Hospital, Inc. Anesthesiology CurrentSince Mar 4, 2013 Accepting new patients
Wayne Memorial Hospital Inc CurrentSince Dec 26, 2023 Accepting new patients
Sampson Regional Medical Services LLC Anesthesiology CurrentSince Jun 28, 2010 Accepting new patients
Bladen Healthcare LLC CurrentSince Aug 25, 2013 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc CurrentSince Dec 18, 2015 Accepting new patients
East Carolina Anesthesia Associates, PLLC Registered Nurse PastSince Jan 1, 2006 Accepting new patients
Ahp of North Carolina, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

607 Beaman St
Clinton, NC 28328
Phone (910) 590-8729

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

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

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

210 Medical Pavilion Dr
Raeford, NC 28376
Phone (910) 904-8000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1497805287",
    "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": "THOMASSON",
        "first_name": "GLENN",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "073405",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "118027",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052825",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00601428",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.