Individual provider Active NPI

Andrea Kathryn Kottmeier

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
National Provider Identifier
1003248857
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
161170 Issued in TN
Practice address
1311 Dowell Springs Blvd
Knoxville, TN 37909-2454
Phone
(865) 588-5121
NPI assigned
Aug 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 161170 TN Primary

Addresses

Primary practice location

1311 Dowell Springs Blvd
Knoxville, TN 37909-2454

Mailing address

2506 Holston River Dr
Rutledge, TN 37861-4330
Phone (865) 919-5993

Other practice location 1

110 Hospital Dr
Jefferson City, TN 37760-5281
Phone (865) 471-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131111001129 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860628377 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Tennessee, HSC, College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Gastroenterology Anesthesia Associates, LLCGroup PAC ID 8325357155, 7 clinicians

Practice addresses (Care Compare)

11440 Parkside Dr
Suite 100
Knoxville, TN 37934-2658
Phone (865) 588-5121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161170TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Anesthesia Group, PC CurrentSince Oct 2, 2013 Accepting new patients
Knoxville Gastroenterology Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 3, 2018 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients

Locations

310 N State of Franklin Rd
Ste 202
Johnson City, TN 37604
Phone (423) 434-3700

Dept 888089
Knoxville, TN 37995

1311 Dowell Springs Blvd
Knoxville, TN 37909
Phone 86558851211606

11440 Parkside Dr
Ste 100
Knoxville, TN 37934
Phone (865) 622-3442

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

629 Delozier Way
#100
Powell, TN 37849
Phone (865) 622-3442

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1375574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1003248857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 HOLSTON RIVER DR",
            "city": "RUTLEDGE",
            "state": "TN",
            "postal_code": "378614330",
            "telephone_number": "865-919-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 DOWELL SPRINGS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092454",
            "telephone_number": "865-588-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "TN",
            "postal_code": "377605281",
            "country_code": "US",
            "telephone_number": "865-471-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTTMEIER",
        "first_name": "ANDREA",
        "middle_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-04",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "161170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.