Mary M Pena, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

15607 Issued in TN

Practice address

6019 Walnut Grove Rd
Memphis, TN 38120-2113

Phone

(901) 226-5000

NPI assigned

Jul 30, 2009

Last updated

Oct 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR, TN, MS3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Anesthesia Associates PLLCGroup PAC ID 6406023142, 85 clinicians

Willow Anesthesia Services LLCGroup PAC ID 9234279183, 52 clinicians

American Anesthesiology of Tennessee PCGroup PAC ID 9931001922, 296 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baxter Health Hospital, Mountain Home, AR, CCN 040027
• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Arkansas Anesthesia Associates, PLLC.

  • Anesthesiology Physician
  • Benton, AR
  • NPI 1497023360

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Willow Anesthesia Services LLC

  • Certified Registered Nurse Anesthetist
  • Oxford, MS
  • NPI 1205169521

  TN

  Medicare reassignment Care Compare group
• East Memphis Anesthesia Services PLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1578592663

  Multi-Specialty

  Medicare reassignment NPD
• Lifelinc Anesthesia, PLLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1801021464

  MS, Multi-Specialty

  Medicare reassignment NPD
• Medical Anesthesia Group, PA

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1679527501

  Multi-Specialty

  Medicare reassignment NPD
• Northstar Anesthesia of Tennessee, PLLC

  • Anesthesiology Physician
  • McMinnville, TN
  • NPI 1821390451

  Multi-Specialty

  Medicare reassignment NPD
• Ut Regional One Physicians Inc

  • Surgery Physician
  • Memphis, TN
  • NPI 1093130585

  Multi-Specialty

  Medicare reassignment NPD
• Arkansas Methodist Hospital Corporation

  dba Paragould Anesthesia Group

  • Anesthesiology Physician
  • Paragould, AR
  • NPI 1861593816

  Multi-Specialty

  Medicare reassignment NPD
• Lifelinc Anesthesia V, P.a.

  • Anesthesiology Physician
  • West Memphis, AR
  • NPI 1063907244

  Multi-Specialty

  Medicare reassignment NPD
• Baxter County Regional Hospital Inc

  dba BRMC Anesthesia

  • Anesthesiology Physician
  • Mountain Home, AR
  • NPI 1114178753
  Medicare reassignment
• American Anesthesiology of Tennessee, P.C.

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
  • NPI 1245279777

  Nurse Anesthetist, Certified Registered

  NPD

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

• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• Baxter County Regional Hospital Inc

  dba BRMC Professional Fees

  • General Acute Care Hospital
  • Mountain Home, AR
  • NPI 1033147921
  Care Compare affiliation
• Baxter County Regional Hospital, Inc

  dba Baxter Health

  • General Acute Care Hospital
  • Mountain Home, AR
  • NPI 1881788933
  Care Compare affiliation

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1043441652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "901-682-2872",
            "fax_number": "901-682-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 WALNUT GROVE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202113",
            "telephone_number": "901-226-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 Cresthaven Rd",
            "address_2": "SUITE 150",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381190800",
            "country_code": "US",
            "telephone_number": "901-682-2872",
            "fax_number": "901-682-9316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA183034",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "RN157932",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "15607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180258001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara M. Pellegrin, NNP
• Nicholas Pelliccio, MD
• Lauren Brittany Pelts
• Kristen K Pembroke, CRNA
• Ernesto Antonio Pena-Tejeda
• Tama Delana Pence, LPC-MHSP
• Landon Pendergrass, M.D.
• Melody Jean Pendleton Greene, D.D.S.
• Teisha Lashae Pendleton
• Bradford Daniel Pendley, PH.D., M.D.

• Certified Registered Nurse Anesthetist in Memphis, TN
• Providers in Memphis, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.