Individual provider Active NPI

Justin Wilson McMahan

  • Certified Registered Nurse Anesthetist
  • Greenville, NC
National Provider Identifier
1619747920
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
008244 Issued in NC
Practice address
2430 Emerald PL Ste 201
Greenville, NC 27834-5743
Phone
(240) 422-4453
NPI assigned
Jan 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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 008244 NC Primary

Addresses

Primary practice location

2430 Emerald PL Ste 201
Greenville, NC 27834-5743

Mailing address

2430 Emerald PL Ste 201
Greenville, NC 27834-5743
Phone (864) 828-3692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260515000340 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244709699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2430 Emerald PL
Suite 201
Greenville, NC 27834-5743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008244NCMDCertified Registered Nurse Anesthetist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1619747920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL STE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345743",
            "telephone_number": "864-828-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL STE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345743",
            "telephone_number": "240-422-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "JUSTIN",
        "middle_name": "WILSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "008244",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 5, 2026; 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.