Active NPI
Richard Gerry Middleton, CRNA
- Certified Registered Nurse Anesthetist
- Goldsboro, NC
National Provider Identifier
1942428677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 215106
- Practice address
- 2700 Wayne Memorial Dr
Goldsboro, NC 27534-9459 - Phone
- (919) 731-6068
- Fax
- (919) 731-6025
- NPI assigned
- Apr 20, 2007
- Last updated
- Oct 16, 2015
- Sex
- Male
- 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 | 215106 | NC | Primary |
Addresses
Primary practice location
2700 Wayne Memorial Dr
Goldsboro, NC 27534-9459
Mailing address
2700 Wayne Memorial Drive
Goldsboro, NC 27534-9459
Phone (919) 731-6142
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8052817 | Medicaid | NC | |
| P00406464 | Other | NC | RAILROAD-MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215106 | NC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayne Health Physicians | Current | Accepting new patients |
Locations
2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060
Organizations & group practices 2
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.
-
dba UNC Health Wayne
- General Acute Care Hospital
- Goldsboro, NC
- NPI 1750353462
-
- Clinic/Center
- Goldsboro, NC
- NPI 1396978169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1942428677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 WAYNE MEMORIAL DRIVE",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275349459",
"telephone_number": "919-731-6142",
"fax_number": "919-731-6966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 WAYNE MEMORIAL DR",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275349459",
"telephone_number": "919-731-6068",
"fax_number": "919-731-6025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDLETON",
"first_name": "RICHARD",
"middle_name": "GERRY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-20",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "215106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8052817",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD-MEDICARE",
"identifier": "P00406464",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Goldsboro, NC
- Gregory S Metcalf, MD
- Jobe Coy Metts III, MD
- Graham Scott Meyer, MD FACEP FAAEM
- Igor Duane Middlebrook, DO
- Clifton Eugene Middleton II
- Mighty Warriors Christian Fellowship (Theopathic Health & Wellness Institute)
- Miller and Associates Six PLLC (Miller and Associates)
- Allie Lowell Miller, OTD, OTR/L
- Catherine B Miller, CRNA
- Luke Miller
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.