Individual provider Active NPI

Sandra Lyn O'Rourke, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, NC
National Provider Identifier
1790825610
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4796 Issued in NC
Practice address
2430 Emerald PL
Suite 201
Greenville, NC 27834-5784
Phone
(252) 752-2140
Fax
(252) 752-3949
NPI assigned
Feb 8, 2007
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4796 NC Primary
Registered Nurse 163W00000X 104237 NC

Addresses

Primary practice location

2430 Emerald PL
Suite 201
Greenville, NC 27834-5784

Mailing address

2430 Emerald PL Ste 201
Greenville, NC 27834-5743
Phone (252) 752-2140

Other identifiers 1

IdentifierTypeStateIssuer
8050948MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100601000574 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103955190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

2430 Emerald PL
Suite 103
Greenville, NC 27834-5743
Phone (252) 752-2140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104237NCMDRegistered Nurse
4796NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Registered Nurse CurrentSince Jun 1, 2010 Accepting new patients

Locations

2080 W Arlington Blvd
Ste B
Greenville, NC 27834
Phone (252) 752-2140

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2430 Emerald Pl
Ste 201
Greenville, NC 27834
Phone (252) 752-2140

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1790825610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL STE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345743",
            "telephone_number": "252-752-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL",
            "address_2": "SUITE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345784",
            "telephone_number": "252-752-2140",
            "fax_number": "252-752-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "SANDRA",
        "middle_name": "LYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "4796",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "104237",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050948",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.

Verify at the official NPI Registry.