Individual provider Active NPI

Jeremy Langille

  • Certified Registered Nurse Anesthetist
  • Lenoir, NC
National Provider Identifier
1982731030
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
312108 Issued in NC
Practice address
321 Mulberry St SW
Lenoir, NC 28645-5720
Phone
(828) 757-5100
NPI assigned
Feb 27, 2007
Last updated
Aug 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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 312108 NC Primary
Certified Registered Nurse Anesthetist 367500000X R813945 MS

Addresses

Primary practice location

321 Mulberry St SW
Lenoir, NC 28645-5720

Mailing address

2101 Highway 90
Gautier, MS 39553-5340

Other practice location 1

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 809-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190927001248 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941191852 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caldwell Memorial Hospital IncGroup PAC ID 5395646970, 212 clinicians
Watauga Medical Center IncGroup PAC ID 2668377474, 95 clinicians

Practice addresses (Care Compare)

321 Mulberry St SW
Lenoir, NC 28645-5720
Phone (828) 757-5100

336 Deerfield Rd
Boone, NC 28607-5008
Phone (828) 262-4133

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R813945MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Medical Center Inc CurrentSince Jun 18, 2020 Accepting new patients
Caldwell Memorial Hospital Inc. CurrentSince Aug 16, 2019 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 18, 2020 Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Jun 18, 2020 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
Watauga Medical Center, Inc. Current Accepting new patients
Watauga Medical Center Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 18, 2020 Accepting new patients
Caldwell Memorial Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Aug 16, 2019 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients

Locations

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

321 Mulberry St SW
Lenoir, NC 28645
Phone (828) 757-5100

Organizations & group practices 9

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 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1982731030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MULBERRY ST SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455720",
            "telephone_number": "828-757-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2809 Denny Ave",
            "address_purpose": "LOCATION",
            "city": "Pascagoula",
            "state": "MS",
            "postal_code": "395815301",
            "country_code": "US",
            "telephone_number": "228-809-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGILLE",
        "first_name": "JEREMY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "312108",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R813945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.