JUSTIN G GATES, CRNA — NPI 1114203635 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered in WARREN, AR)

CMS-1500 Box 24J / 33a • NPI

1114203635

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

367500000X (CMS 43)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered

Box 32 Service Location & ZIP+4

404 S BRADLEY ST, WARREN, AR, 71671-3459

✓ 9-Digit EDI 837 ZIP+4 (71671-3459)

Practice Phone & Referral Fax

(870) 226-3731

Fax: (952) 442-3620

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1114203635 (JUSTIN G GATES, CRNA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1114203635` (NPI-1 Individual Practitioner)
Provider / Legal Name	JUSTIN G GATES, CRNA
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: `367500000X` (Nurse Anesthetist, Certified Registered)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	404 S BRADLEY ST, WARREN, AR, 71671-3459
Practice Telephone / Fax	Tel: (870) 226-3731 \| Fax: (952) 442-3620
Administrative Mailing Address	400 E 10TH ST, WACONIA, MN, 55387-4552
Enumeration & Last Sync	Enumerated: 2011-10-28 \| CMS Record Updated: 2011-11-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

404 S BRADLEY ST, WARREN, AR, 71671-3459

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Plain-English Taxonomy & CMS Crosswalk (367500000X)

What Does Taxonomy Code 367500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 43 (Certified Registered Nurse Anesthetist (CRNA))
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Anesthetist, Certified Registered for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JUSTIN G GATES, CRNA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: AR \| License: `C02886` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JUSTIN G GATES, CRNA (NPI #1114203635)