NPIMap

Organization Active NPI

Tennessee Valley Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
National Provider Identifier
1053881706
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TENNESSEE VALLEY ANESTHESIA ASSOCIATES, LLC
Practice address
310 N State of Franklin Rd Ste 202
Johnson City, TN 37604-6063
Phone
(423) 434-3700
Fax
(423) 929-0662
NPI assigned
Nov 26, 2018
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Jeff Perry
Title
VP of RCM
Phone
(502) 418-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

310 N State of Franklin Rd Ste 202
Johnson City, TN 37604-6063

Mailing address

PO Box 739579
Dallas, TX 75373-9579
Phone (888) 717-5383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190111001324 TN Part B Supplier - Clinic/Group Practice 1254677222 Receives reassigned benefits from 31 practitioners
Practice locations: Johnson City, TN

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1053881706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 739579",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753739579",
            "telephone_number": "888-717-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 202",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046063",
            "telephone_number": "423-434-3700",
            "fax_number": "423-929-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VALLEY ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP OF RCM",
        "authorized_official_telephone_number": "502-418-4700"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.