Individual provider Active NPI

Peter Ganun, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, NC
National Provider Identifier
1861458648
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
306 Issued in NC
Practice address
317 Western Blvd
Jacksonville, NC 28546-6338
Phone
(910) 577-2471
Fax
(910) 577-2634
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 181130 NC
Certified Registered Nurse Anesthetist 367500000X 181130 NC
Certified Registered Nurse Anesthetist 367500000X 306 NC Primary

Addresses

Primary practice location

317 Western Blvd
Jacksonville, NC 28546-6338

Mailing address

214 Bates Retreat
Middle Point Village
Hampstead, NC 28443-2474
Phone (910) 270-0737

Other practice location 1

1801 S 17th St
Wilmington, NC 28401-6443
Phone (910) 763-4555 ext. 109

Other practice location 2

2430 Emerald Pl Ste 201
Greenville, NC 27834-5743
Phone (252) 752-2140 ext. 102

Other identifiers 2

IdentifierTypeStateIssuer
6907604MedicaidNC
562014989OtherNCTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050428000890 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224077201 Reassigns benefits to 4 organizations
I20190104000909 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224077201

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Anesthesia Associates PAGroup PAC ID 1456251057, 67 clinicians
Carolina Regional Anesthesia PLLCGroup PAC ID 5496921769, 51 clinicians

Practice addresses (Care Compare)

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-3491

242 A 9TH Ave Dr NE
Hickory, NC 28601-3828
Phone (828) 327-6673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
306NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Registered Nurse CurrentSince Jan 1, 2022 Accepting new patients
Anesthesia Care Services, PA Nurse Anesthetist, Certified Registered CurrentSince Apr 28, 2025 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Nov 1, 2018 Accepting new patients
Carolina Regional Anesthesia PLLC Anesthesiology CurrentSince Mar 15, 2019 Accepting new patients
Carolina Anesthesia Associates PA Anesthesiology CurrentSince Mar 15, 2019 Accepting new patients

Locations

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

2730 Georgia Rd
Franklin, NC 28734
Phone (828) 349-3636

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

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

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

704 Wh Smith Blvd
Greenville, NC 27834
Phone (252) 758-8181

242A 9th Avenue Dr NE
Hickory, NC 28601
Phone (828) 327-6673

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

1801 S 17th St
Wilmington, NC 28401
Phone (910) 763-4555

2800 Ashton Dr
Ste 100
Wilmington, NC 28412
Phone (910) 794-8842

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

300 Community Dr
Plandome, NY 11030

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

Organizations & group practices 5

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1861458648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BATES RETREAT",
            "address_2": "MIDDLE POINT VILLAGE",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284432474",
            "telephone_number": "910-270-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-577-2471",
            "fax_number": "910-577-2634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016443",
            "country_code": "US",
            "telephone_number": "910-763-4555 x109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2430 Emerald Pl Ste 201",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345743",
            "country_code": "US",
            "telephone_number": "252-752-2140 x102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANUN",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "181130",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "181130",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6907604",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "562014989",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.