Gabriel Chad Underwood, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C002795 Issued in AR

Practice address

2710 Rife Medical LN
Anesthesia Department
Rogers, AR 72758-1452

Phone

(913) 642-4900

Fax

(913) 381-0979

NPI assigned

Dec 21, 2009

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 3

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Anesthesia of Arkansas Professional CorporationGroup PAC ID 6406077460, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Premier Anesthesia of Arkansas Professional Corporation

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1932519485

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1699004648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450507",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 RIFE MEDICAL LN",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "GABRIEL",
        "middle_name": "CHAD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-21",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BREASTCARE",
            "identifier": "771111701",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182910001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200274730A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meosha Tye, LCSW
• U Save RX, Inc.
• Katie Lyn Ubben, MS, LAC
• Bradley Robert Umbarger, MD
• Tom Umphress
• Kellie Nicole Underwood
• Kerry Ann Underwood, MS, LPC, LMFT
• United Medical, PA
• Universal Medical Supply Corp
• Unruh Chiropractic & Wellness Center

• Certified Registered Nurse Anesthetist in Rogers, AR
• Providers in Rogers, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.