Active NPI
Luis Gustavo Gonzalez, MD
- Anesthesiology Physician
- Reidsville, NC
National Provider Identifier
1659341998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 000031135
- Practice address
- 618 S Main St
Anesthesia Dept
Reidsville, NC 27320-5020 - Phone
- (336) 951-1010
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 000031135 | NC | Primary |
Addresses
Primary practice location
618 S Main St
Anesthesia Dept
Reidsville, NC 27320-5020
Mailing address
PO Box 2627
Reidsville, NC 27323-2627
Phone (336) 951-1010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8926472 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000031135 | NC | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1659341998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2627",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273232627",
"telephone_number": "336-951-1010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 S MAIN ST",
"address_2": "ANESTHESIA DEPT",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273205020",
"telephone_number": "336-951-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "LUIS",
"middle_name": "GUSTAVO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "000031135",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8926472",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reidsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.