KEVIN A. ROARK CRNA
NPI 1366677403
Nurse Anesthetist, Certified Registered in Greenville, NC

Q: What is Kevin Roark's NPI number?

The NPI number for Kevin Roark is 1366677403. It was assigned to this individual provider in the NPPES registry on May 19, 2009.

Q: What is Kevin Roark's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Roark was last updated on May 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 19, 2009Accepts Medicare Assignment

2430 EMERALD PL, SUITE 201, GREENVILLE, NC 27834(252) 752-2140(252) 752-3949 Get Directions Write a Review

NPPES record last updated: May 24, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Kevin A. Roark Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN A. ROARK CRNA (NPI 1366677403) is an individual nurse anesthetist, certified registered in Greenville, North Carolina, licensed in North Carolina (082168) and active in the NPI registry since May 2009. He is a graduate of Other (2009).

NPPES Registry Identity

NPI1366677403

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameKEVIN A. ROARKCredential: CRNA

Location Address2430 EMERALD PL, SUITE 201Greenville, NC 27834-5784

Mailing Address2430 Emerald Pl, Suite 201Greenville, NC 27834-5784 · (252) 752-2140 · Fax (252) 752-3949

Phone(252) 752-2140

Fax(252) 752-3949

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateMay 19, 2009

Last NPPES UpdateMay 24, 2010

✔ NPI 1366677403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in NC · 082168

Definition

(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.

Also ListedRegistered NurseTaxonomy 163W00000X · License 215024 (NC)

2430 EMERALD PL, Greenville, NC 27834

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Other Identifiers 3

OtherP00742958NC · Railroad Medicare

Medicaid8053549NC

Medicare PIN2611064NC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin A. Roark Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294887410

PECOS Enrollment IDI20251209004252

Medicare Billing Reassignments

Medicare enrollment records show Kevin Roark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Western Anesthesia Associates LLC

1,897 mi

Anesthesiology

630 MEDICAL DR
Bountiful, UT 84010

Reassigned Medicare billing, Utah enrollment
24 clinicians in this Medicare group

NPI 1174566277 (801) 299-2160

Mt Ogden Anesthesia Group LLC

1,902 mi

Nurse Anesthetist, Certified Registered

3480 WASHINGTON BLVD STE 105
Ogden, UT 84401

Reassigned Medicare billing, Utah enrollment
33 clinicians in this Medicare group

NPI 1770999807 (801) 392-0385

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27834 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRANDI DAVIS SPIEWAK CRNA

Nurse Anesthetist, Certified Registered