NOVANT HEALTH BRUNSWICK ENDOSCOPY CRNAS
NPI 1023532686
Nurse Anesthetist, Certified Registered in Supply, NC

NPI Status: Active since July 26, 2017

Contact Information

13 MEDICAL CAMPUS DRIVE
SUITE 101
SUPPLY, NC
ZIP 28462
Phone: (910) 721-4300
Fax: (910) 721-4309

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  • Organization
  • Nurse Anesthetist, Certified Registered
  • CLIA Number: 34D2142964
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 01-22-2028

About NOVANT HEALTH BRUNSWICK ENDOSCOPY CRNAS

This page provides the complete NPI Profile along with additional information for Novant Health Brunswick Endoscopy Crnas, a provider established in Supply, North Carolina operating as a Nurse Anesthetist, Certified Registered. The healthcare provider is registered in the NPI registry with number 1023532686 assigned on July 2017. The practitioner's primary taxonomy code is 367500000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Novant Health Brunswick Endoscopy Crnas. The authorized official of this NPI record is Shelborn Stevens (President & Coo)

NPI
1023532686
Provider Legal Name
NOVANT HEALTH BRUNSWICK ENDOSCOPY CENTER, LLC
Other Organization Name
NOVANT HEALTH BRUNSWICK ENDOSCOPY CRNAS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
13 MEDICAL CAMPUS DRIVE SUITE 101 SUPPLY, NC 28462
Location Phone
(910) 721-4300
Location Fax
(910) 721-4309
Mailing Address
2085 FRONTIS PLAZA BLVD WINSTON SALEM, NC 27103
Mailing Phone
(336) 277-7226
Mailing Fax
(910) 721-4309
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-26-2017
Last Update Date
07-26-2017
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Anesthetist, Certified Registered

Taxonomy Code
367500000X
Type
Physician Assistants & Advanced Practice Nursing Providers
Taxonomy Description
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SHELBORN STEVENS

Authorized Official Title
PRESIDENT & COO
Authorized Official Phone
(910) 721-1456

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D2142964
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
January 23, 2026
Certificate Expiration Date
January 22, 2028
Laboratory Director
DYLAN SALRIN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Novant Health Brunswick Endoscopy Crnas to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1023532686, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
2
Doubled → 4
Pos 4
3
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
3
Unchanged
Pos 7
2
Doubled → 4
Pos 8
6
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 5 → 10 → 1 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 4 + 3 + 1 + 0 + 3 + 4 + 6 + 1 + 6 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1023532686.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023532686, enumerated as an "organization" on July 26, 2017.

The provider is located at 13 MEDICAL CAMPUS DRIVE SUITE 101 SUPPLY, NC 28462 and the phone number is (910) 721-4300.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.