Jennifer Bolin Gould, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

238403 Issued in NC

Practice address

10628 Park Rd
Anesthesia Services
Charlotte, NC 28210-8407

Phone

(704) 667-1970

Fax

(704) 667-1684

NPI assigned

Jan 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Novant Health Ballantyne Medical Center LLCGroup PAC ID 4880065143, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• CHS Anesthesia Services Group Inc

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1346649415
  Medicare reassignment Care Compare group NPD
• Novant Health Ballantyne Medical Center LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1760190607

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Brunswick Community Hospital, LLC

  • Certified Registered Nurse Anesthetist
  • Bolivia, NC
  • NPI 1669725198

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment NPD
• Medical Park Hospital LLC

  • Specialist
  • Winston-Salem, NC
  • NPI 1003867516
  Medicare reassignment NPD
• Novant Health Clemmons Outpatient Surgery, LLC

  • Ambulatory Surgical Clinic/Center
  • Clemmons, NC
  • NPI 1528521887
  Medicare reassignment NPD
• Novant Health Kernersville Outpatient Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Kernersville, NC
  • NPI 1750892659
  Medicare reassignment NPD
• Novant Health Matthews Medical Center LLC

  • Specialist
  • Matthews, NC
  • NPI 1184782419
  Medicare reassignment NPD
• Novant Health Mint Hill Medical Center, LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1063910404

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Rowan Medical Center LLC

  • Neurology Physician
  • Salisbury, NC
  • NPI 1508931544

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Thomasville Medical Center, LLC

  • Specialist
  • Thomasville, NC
  • NPI 1033160205

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Presbyterian Sameday Surgery Center at Ballantyne LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1215061049
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health Ballantyne Medical Center LLC

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1740998020
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1982942587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 GOLF ACRES DR",
            "address_2": "STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085906",
            "telephone_number": "704-512-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10628 PARK RD",
            "address_2": "ANESTHESIA SERVICES",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108407",
            "telephone_number": "704-667-1970",
            "fax_number": "704-667-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JENNIFER",
        "middle_name": "BOLIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "238403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8054354",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN153",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Patterson Gotwald, M.D.
• Claire Hicks Gouch
• John B Gouch Sr., DDS
• Kalyn Goudreau
• Chelsea Gough
• Jonathan Willis Gould, PH.D.
• Jessica C Gounis, ST
• Megan Gourd, LCSWA
• Blanton Craig Gourley, MD
• Gregg Matthews Gouyd II

• Certified Registered Nurse Anesthetist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.