Individual provider Active NPI

Robert Joshua Caudle, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1639328669
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
193112 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 713-2755
Fax
(336) 713-0660
NPI assigned
Sep 15, 2008
Last updated
Mar 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X CCNA 081859 NC
Certified Registered Nurse Anesthetist 367500000X 193112 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) 713-2755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090504000679 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375691124 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical CenterGroup PAC ID 0547178907, 105 clinicians

Practice addresses (Care Compare)

810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone (828) 326-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CCNA 081859NCMDCritical Access Hospital
193112NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Center Current Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Mar 13, 2019 Accepting new patients
Iredell Memorial Hospital Incorporated CurrentSince Jan 7, 2019 Accepting new patients
Catawba Valley Medical Center CurrentSince Jan 14, 2019 Accepting new patients
Iredell Memorial Hospital, Incorporated CurrentSince Jan 7, 2019 Accepting new patients
Catawba Valley Medical Center CurrentSince Jan 14, 2019 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince May 22, 2018 Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 22, 2018 Accepting new patients

Locations

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

180 Parkwood Dr
Elkin, NC 28621
Phone (336) 527-7000

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

200 Hospital Ave
Jefferson, NC 28640
Phone (336) 246-7101

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

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

Organizations & group practices 8

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.

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1639328669",
    "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": "336-713-2755",
            "fax_number": "336-713-0660"
        },
        {
            "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": "336-713-2755",
            "fax_number": "336-713-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDLE",
        "first_name": "ROBERT",
        "middle_name": "JOSHUA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NC",
            "license": "CCNA 081859",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "193112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Mar 30, 2018; 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.