NPIMap

Individual provider Active NPI

Jon Fredrick Faigle, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1851791107
Registry record updated Aug 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
249997 Issued in NC
Practice address
145 Kimel Park Dr
Suite 120
Winston Salem, NC 27103-6984
Phone
(336) 768-3212
NPI assigned
Aug 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2014

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 249997 NC Primary

Addresses

Primary practice location

145 Kimel Park Dr
Suite 120
Winston Salem, NC 27103-6984

Mailing address

145 Kimel Park Dr
Suite 120
Winston Salem, NC 27103-6984
Phone (336) 768-3212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141017001085 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244451144 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Feb 1, 2023 Accepting new patients
Regional Anesthesia, PLLC CurrentSince Apr 3, 2017 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Oct 12, 2023 Accepting new patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Apr 23, 2023 Accepting new patients
Piedmont Triad Anesthesia, PA Anesthesiology CurrentSince Sep 1, 2014 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Feb 1, 2023 Accepting new patients
Ambulatory Anesthesia of Pinehurst, PA Anesthesiology Past Accepting new patients

Locations

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

800 Clayton Rd
Durham, NC 27703
Phone (919) 560-2536

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

145 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-1770

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1408752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408752000000",
    "number": "1851791107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-768-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-768-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIGLE",
        "first_name": "JON",
        "middle_name": "FREDRICK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-23",
        "last_updated": "2014-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "249997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2014; 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.