Individual provider Active NPI

Matthew Stewart, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, TN
National Provider Identifier
1104378538
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
187385 Issued in TN
Practice address
100 Northcrest Dr
Springfield, TN 37172-3927
Phone
(615) 384-1529
Fax
(615) 384-1765
NPI assigned
Nov 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 187385 TN Primary

Addresses

Primary practice location

100 Northcrest Dr
Springfield, TN 37172-3927

Mailing address

3340 Players Club Pkwy
Suite 350
Memphis, TN 38125-8933
Phone (901) 844-1590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170323002284 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870878341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia VIII PLLCGroup PAC ID 3173984762, 155 clinicians

Practice addresses (Care Compare)

435 2ND St
Newport, TN 37821-3703
Phone (423) 625-2200

Hospital & facility affiliations

  • Tristar Northcrest Medical Center Hospital, Springfield, TN, CCN 440065
  • Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
187385TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelinc Anesthesia VIII PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 28, 2023 Accepting new patients
Lifelinc Anesthesia II, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 30, 2016 Accepting new patients

Locations

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

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

Organizations & group practices 2

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": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1104378538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PLAYERS CLUB PKWY",
            "address_2": "SUITE 350",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258933",
            "telephone_number": "901-844-1590",
            "fax_number": "901-855-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTHCREST DR",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723927",
            "telephone_number": "615-384-1529",
            "fax_number": "615-384-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MATTHEW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "187385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.