Individual provider Active NPI

Timothy Joe Carter II, CRNA

  • Certified Registered Nurse Anesthetist
  • Gilbert, AZ
National Provider Identifier
1003295916
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
22032 Issued in TN
Practice address
1900 N. Higley Road
Gilbert, AZ 85234-1604
Phone
(480) 981-2400
Fax
(480) 981-2407
NPI assigned
May 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CRNA1137 AZ
Certified Registered Nurse Anesthetist 367500000X 22032 TN Primary

Addresses

Primary practice location

1900 N. Higley Road
Gilbert, AZ 85234-1604

Mailing address

4838 E. Baseline Road
Suite 108
Mesa, AZ 85206-4672
Phone (480) 981-2400

Other identifiers 1

IdentifierTypeStateIssuer
029145MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, SC, NC, WV, AL, VA, PA7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
I20161214001764 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799099941 Reassigns benefits to 3 organizations
I20190219000885 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799099941 Reassigns benefits to 1 organization
I20190227001663 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799099941 Reassigns benefits to 1 organization
I20190305001197 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799099941 Reassigns benefits to 1 organization
I20191120003424 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799099941 Reassigns benefits to 1 organization
I20201014002270 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799099941 Reassigns benefits to 1 organization
I20220301002865 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799099941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

Hospital & facility affiliations

  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22032TNMDPharmacist
CRNA1137AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Dec 6, 2016 Accepting new patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
St Clair Anesthesiology Associates Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 28, 2022 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Jun 1, 2025 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

1000 Bower Hill Rd
Pittsburgh, PA 15243
Phone (412) 344-6600

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1003295916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4838 E. BASELINE ROAD",
            "address_2": "SUITE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064672",
            "telephone_number": "480-981-2400",
            "fax_number": "480-981-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N. HIGLEY ROAD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341604",
            "telephone_number": "480-981-2400",
            "fax_number": "480-981-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "TIMOTHY",
        "middle_name": "JOE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA1137",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "22032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029145",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.