Robert I Goulart, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN977 Issued in SC

Practice address

701 Grove Rd
2ND Floor Anesthesia Dept
Greenville, SC 29605-5611

Phone

(864) 455-7111

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wallace Thomson Hospital

  • Medical Specialty Clinic/Center
  • Union, SC
  • NPI 1588872584
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1669429064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 ENTERPRISE BLVD",
            "address_2": "SUITE 250",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156300",
            "telephone_number": "864-454-0888",
            "fax_number": "864-454-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "address_2": "2ND FLOOR ANESTHESIA DEPT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055611",
            "telephone_number": "864-455-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULART",
        "first_name": "ROBERT",
        "middle_name": "I",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "APRN977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH IND ID",
            "identifier": "20010908",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0919",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH GROUP",
            "identifier": "20031911",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCARE RAILROAD",
            "identifier": "430062057",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alaina Holroyd Goss, RN
• Stacy Goss, LMT
• Matthew Ryan Gossage, M.D.
• Dawn Marie Gossett, C.P.S.S.
• Gary Morgan Goudelock, MD
• Phillip David Gould, DMD
• Janey Capers Newland Gour
• Scott Gourley, PHARMD
• Ana Elizabeth Gowani, MD
• Zain Sherali Gowani

• Certified Registered Nurse Anesthetist in Greenville, SC
• Providers in Greenville, SC by specialty
• Certified Registered Nurse Anesthetist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.

Verify at the official NPI Registry.