Individual provider Active NPI

Roberta White Thompson, CRNA

  • Certified Registered Nurse Anesthetist
  • Durham, NC
National Provider Identifier
1508979576
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
036651 Issued in NC
Practice address
Erwin Road
Durham, NC 27710-0001
Phone
(919) 684-3595
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 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 036651 NC Primary

Addresses

Primary practice location

Erwin Road
Durham, NC 27710-0001

Mailing address

249 Overlook Dr
Roanoke Rapids, NC 27870-8823
Phone (252) 537-9928

Other identifiers 1

IdentifierTypeStateIssuer
8051303MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040624001640 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587640230 Reassigns benefits to 1 organization
I20150406001249 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587640230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone (252) 438-4143

830 Rockford St
Mount Airy, NC 27030-5322
Phone (336) 719-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036651NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Anesthesia Associates PA Nurse Anesthetist, Certified Registered CurrentSince Jan 11, 2015 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2014 Accepting new patients
Amsol Anesthetists of Henderson PLLC Past Accepting new patients
Carolina Anesthesia Group PLLC Past Accepting new patients
Regional Anesthesia, PLLC Past Accepting new patients

Locations

82 Patton Ave
Ste 510
Asheville, NC 28801
Phone (828) 210-9386

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

1007 Gregory Dr
Roanoke Rapids, NC 27870
Phone (252) 535-6478

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

101 Surgeons Dr
Myrtle Beach, SC 29579
Phone (803) 504-7194

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1508979576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 OVERLOOK DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278708823",
            "telephone_number": "252-537-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ERWIN ROAD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-684-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ROBERTA",
        "middle_name": "WHITE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "036651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051303",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.