Active NPI
Gwendolyn Sue Martinez, CRNA
- Certified Registered Nurse Anesthetist
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024166964
- Practice address
- 3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880 - Phone
- (919) 882-0705
- Fax
- (919) 873-9821
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- 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 | 0024166964 | VA | Primary |
Addresses
Primary practice location
3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Mailing address
3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 882-0705
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851327993 | Medicaid | VA |
Other names 1
- Gwendolyn Sue Braswell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024166964 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Anesthesia Group, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Northstar Anesthesia of Virginia, LLC | Current | Accepting new patients | |
| Clearwater Pain Management Associates | Past | Accepting new patients | |
| Roswell Hospital Corporation | Past | Accepting new patients | |
| Anesthesia Associates of Pinellas County | Past | Accepting new patients | |
| Roswell Hospital Corporation | Past | Accepting new patients | |
| Deming Hospital Corporation | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784
2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000
736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124
541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700
1500 Dixon St
Ste 101
Fredericksburg, VA 22401
Phone (540) 371-5349
1501 Maple Ave
Ste 300
Richmond, VA 23226
Phone (804) 287-7878
Organizations & group practices 7
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.
-
- Anesthesiology Physician
- Fredericksburg, VA
- NPI 1619149648
Nurse Anesthetist, Certified Registered
-
- Specialist
- Clearwater, FL
- NPI 1396772620
-
- Pain Clinic/Center
- Clearwater, FL
- NPI 1477585883
-
- Pain Medicine (Anesthesiology) Physician
- Deming, NM
- NPI 1386850519
Nurse Anesthetist, Certified Registered
-
- Rural Health Clinic/Center
- Dexter, NM
- NPI 1225161474
-
- Family Medicine Physician
- Roswell, NM
- NPI 1427001759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1851327993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SPRING FOREST RD",
"address_2": "SUITE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162880",
"telephone_number": "919-882-0705",
"fax_number": "919-873-9821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SPRING FOREST RD",
"address_2": "SUITE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162880",
"telephone_number": "919-882-0705",
"fax_number": "919-873-9821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "GWENDOLYN",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2023-10-25",
"certification_date": "2023-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024166964",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851327993",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GWENDOLYN",
"last_name": "BRASWELL",
"middle_name": "SUE",
"credential": "CRNA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.