Individual provider Active NPI

Clifford Fontanilla Gonzales, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1558458042
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2163 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-3069
NPI assigned
Oct 6, 2006
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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 136101 NC
Certified Registered Nurse Anesthetist 367500000X 2163 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-3069

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cfgonzal@wakeehalth.edu Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070112000457 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739189861 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Park Hospital LLCGroup PAC ID 4880595958, 109 clinicians
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians
Gate City Anesthesia, IncGroup PAC ID 8820089329, 19 clinicians

Practice addresses (Care Compare)

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-0600

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-5000

705 Green Valley Rd
Greensboro, NC 27408-7019
Phone (336) 272-0012

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136101NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Park Hospital LLC CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Thomasville Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Current Accepting new patients
Novant Health Mint Hill Medical Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Jun 16, 2025 Accepting new patients
Presbyterian Sameday Surgery Center at Ballantyne LLC Current Accepting new patients
Gate City Anesthesia, Inc CurrentSince Mar 19, 2021 Accepting new patients
The Presbyterian Hospital CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Rowan Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
Presbyterian Sameday Surgery Center at Huntersville LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Clemmons Outpatient Surgery, LLC Current Accepting new patients
Medical Park Hospital LLC CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Jun 16, 2025 Accepting new patients
Brunswick Community Hospital, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
The Presbyterian Hospital CurrentSince Jun 16, 2025 Accepting new patients
Novant Health Kernersville Outpatient Surgery LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jun 16, 2025 Accepting new patients
Forsyth Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2025 Accepting new patients
Piedmont Triad Anesthesia, PA Nurse Anesthetist, Certified Registered PastSince Jul 20, 2004 Accepting new patients

Locations

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

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

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

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

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

21A Oak Branch Dr
Greensboro, NC 27407
Phone (336) 478-2664

705 Green Valley Rd
Greensboro, NC 27408
Phone (336) 272-0012

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

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

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

145 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-1770

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

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

Organizations & group practices 25

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 25

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1558458042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "CLIFFORD",
        "middle_name": "FONTANILLA",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "136101",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "2163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cfgonzal@wakeehalth.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Medical Center Blvd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271570001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.