Individual provider Active NPI

Eugene J Murdock Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Augusta, GA
National Provider Identifier
1770539710
Registry record updated Jun 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN051238 Issued in GA
Practice address
1120 15TH St
RM 2144
Augusta, GA 30912-0004
Phone
(706) 721-3873
Fax
(706) 721-7763
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN051238 GA Primary

Addresses

Primary practice location

1120 15TH St
RM 2144
Augusta, GA 30912-0004

Mailing address

PO Box 28068
Chattanooga, TN 37424-8068
Phone (877) 899-1033

Other identifiers 6

IdentifierTypeStateIssuer
339448OtherGAWELLCARE CMO
000556817DMedicaidGA
550789920OtherGATRICARE
GAN161MedicaidSC
000556817CMedicaidGA
430079465OtherGARRMEDICARE

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
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta University Past Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Au Medical Associates Anesthesia Billing Services, LLC Past Accepting new patients
Anesthesia and Pain Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213488000000",
    "number": "1770539710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28068",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374248068",
            "telephone_number": "877-899-1033",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "address_2": "RM 2144",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3873",
            "fax_number": "706-721-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "EUGENE",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN051238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE CMO",
            "identifier": "339448",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000556817D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "550789920",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GAN161",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000556817C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "430079465",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.