Active NPI
Claude Gregory Diettrich, CRNA
- Certified Registered Nurse Anesthetist
- Roanoke Rapids, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024164474
- Practice address
- 104 Gail Dr
Roanoke Rapids, NC 27870-9202 - Phone
- (252) 533-0413
- NPI assigned
- Aug 16, 2006
- Last updated
- Apr 1, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 044226 | NC | |
| Certified Registered Nurse Anesthetist | 367500000X | 0024164474 | VA | Primary |
Addresses
Primary practice location
104 Gail Dr
Roanoke Rapids, NC 27870-9202
Mailing address
104 Gail Dr
Roanoke Rapids, NC 27870-9202
Phone (252) 533-0413
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8051649 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, VA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
19455 Deerfield Ave
Suite 204
Leesburg, VA 20176-8102
Phone (703) 724-9950
727 N Main St
Emporia, VA 23847-1274
Phone (434) 348-4400
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044226 | NC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Virginia, PC | Current | Accepting new patients | |
| American Anesthesiology of Virginia PC | Current | Accepting new patients | |
| Vidant Medical Group LLC | Current | Accepting new patients | |
| Medstream Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
700 Academy St S
Ahoskie, NC 27910
Phone (252) 209-3614
401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941
250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699
111 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7700
310 S McCaskey Rd
Williamston, NC 27892
Phone (252) 809-6133
19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950
200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000
6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Falls Church, VA
- NPI 1417994872
-
- Anesthesiology Physician
- Richardson, TX
- NPI 1649616160
Nurse Anesthetist, Certified Registered, VA
-
- Multi-Specialty Clinic/Center
- Greenville, NC
- NPI 1477648731
-
- Anesthesiology Physician
- Leesburg, VA
- NPI 1053675199
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Bon Secours Southern Virginia Medical Center
- General Acute Care Hospital
- Emporia, VA
- NPI 1104461276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743465600000",
"number": "1689787640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 GAIL DR",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278709202",
"telephone_number": "252-533-0413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 GAIL DR",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278709202",
"telephone_number": "252-533-0413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETTRICH",
"first_name": "CLAUDE",
"middle_name": "GREGORY",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2025-04-01",
"certification_date": "2025-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "044226",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024164474",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8051649",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke Rapids, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.