Individual provider Active NPI

Stephanie Petrina Noack, M.D.

  • Anesthesiology Physician
  • Murfreesboro, TN
National Provider Identifier
1093855306
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD0000034663 Issued in TN
Practice address
1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone
(615) 893-4480
NPI assigned
Feb 7, 2007
Last updated
Jun 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD0000034663 TN Primary

Addresses

Primary practice location

1272 Garrison Dr
Murfreesboro, TN 37129-2598

Mailing address

1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone (615) 893-4480

Other practice location 1

420 W Main St
Lebanon, TN 37087-3502
Phone (615) 444-1149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040402000704 TN Practitioner - Anesthesiology 7618969106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Florida College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murfreesboro Medical Clinic, P.a.Group PAC ID 4789589227, 176 clinicians

Practice addresses (Care Compare)

1272 Garrison Dr
Murfreesboro, TN 37129-2570
Phone (615) 893-4480

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as apm
Quality
79.78
Promoting interoperability
93.11
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000034663TNMDAnesthesiology Physician
34663TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Medical Clinic, P.a. CurrentSince Jan 6, 2013 Accepting new patients
Murfreesboro Medical Clinic, P.a. CurrentSince Jan 6, 2013 Accepting new patients
Murfreesboro Medical Clinic, P.a. Current Accepting new patients
Institute of Interventional Pain Management PA Past Accepting new patients
Anesthesia Services of Wilson County PLLC Anesthesiology Past Accepting new patients
East Tennessee Anesthesia Services, PLLC Anesthesiology Past Accepting new patients
Anesthesia Services of Middle Tennessee, PLLC Anesthesiology PastSince Sep 1, 2005 Accepting new patients
Southeastern Interventional Pain Physicians, P.a. Past Accepting new patients

Locations

1272 Garrison Dr
Murfreesboro, TN 37129
Phone (615) 867-7925

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1093855306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-893-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-893-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 W Main St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "TN",
            "postal_code": "370873502",
            "country_code": "US",
            "telephone_number": "615-444-1149",
            "fax_number": "615-444-6626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOACK",
        "first_name": "STEPHANIE",
        "middle_name": "PETRINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "MD0000034663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.