Individual provider Active NPI

Kerry J Parker, CRNA

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1083046734
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN17904 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2147
Phone
(423) 778-7608
Fax
(423) 778-2360
NPI assigned
Aug 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN179497 TN
Certified Registered Nurse Anesthetist 367500000X APN17904 TN Primary

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2147

Mailing address

PO Box 11225
Chattanooga, TN 37401-2225
Phone (423) 892-5602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131021001047 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961637301 Reassigns benefits to 1 organization
I20150722004533 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961637301 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Anesthesiology Group, IncGroup PAC ID 1759345192, 23 clinicians
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians

Practice addresses (Care Compare)

1200 16TH Ave
Meridian, MS 39301-4209
Phone (601) 485-6325

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 484-6700

2401 16TH St
Meridian, MS 39301-3950
Phone (601) 482-4181

3340 Players Blub Pkwy
Memphis, TN 38125-8949
Phone (901) 844-1590

634 Leigh Dr
Columbus, MS 39705-3014
Phone (866) 362-6963

Hospital & facility affiliations

  • Ochsner Rush Hospital Hospital, Meridian, MS, CCN 250069
  • Anderson Regional Medical Center Hospital, Meridian, MS, CCN 250104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN179497TNMDRegistered Nurse
903085MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Medical Foundation, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Meridian Anesthesiology Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients
QHG of Hattiesburg Inc Past Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

1200 16th Ave
Meridian, MS 39301
Phone (601) 703-1901

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

2200 Union Ave
Memphis, TN 38104
Phone (901) 274-5813

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

Organizations & group practices 5

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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1083046734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11225",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374012225",
            "telephone_number": "423-892-5602",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7608",
            "fax_number": "423-778-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KERRY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN179497",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN17904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.