Active NPI
Gerard Gilbert Desjardins, CRNA
- Certified Registered Nurse Anesthetist
- Roswell, NM
National Provider Identifier
1700957578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R13732
- Practice address
- 113 E 17TH Street
Roswell, NM 88201 - Phone
- (575) 627-7000
- Fax
- (575) 627-7007
- NPI assigned
- Nov 13, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R13732 | NM | Primary |
Addresses
Primary practice location
113 E 17TH Street
Roswell, NM 88201
Mailing address
PO Box 664
Roswell, NM 88202
Phone (575) 622-4784
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30264 | Other | NM | LOVELACE HEALTH PLAN |
| 430055194 | Other | GA | RAILROAD MEDICARE |
| 14331 | Other | NM | PRESBYTERIAN HEALTH PLAN |
| NM016018 | Other | NM | BLUE CROSS |
| 91215 | Medicaid | NM | |
| 50655 | Other | NM | PRESBYTERIAN SALUD |
| 11148 | Other | NM | LOVELACE SALUD |
| 188124400 | Other | FL | DEPT OF LABOR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R13732 | NM | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212451200000",
"number": "1700957578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 664",
"city": "ROSWELL",
"state": "NM",
"postal_code": "88202",
"telephone_number": "575-622-4784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 E 17TH STREET",
"city": "ROSWELL",
"state": "NM",
"postal_code": "88201",
"telephone_number": "575-627-7000",
"fax_number": "575-627-7007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESJARDINS",
"first_name": "GERARD",
"middle_name": "GILBERT",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2008-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "R13732",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE HEALTH PLAN",
"identifier": "30264",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "430055194",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN HEALTH PLAN",
"identifier": "14331",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "NM016018",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "91215",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN SALUD",
"identifier": "50655",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE SALUD",
"identifier": "11148",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "188124400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.