Individual provider Active NPI

Alyse Holmes, CRNA

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1134760630
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26565 Issued in TN
Practice address
1247 Riverfront Pkwy # 100
Chattanooga, TN 37402-2108
Phone
(423) 206-9000
NPI assigned
Oct 5, 2019
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 26565 TN Primary

Addresses

Primary practice location

1247 Riverfront Pkwy # 100
Chattanooga, TN 37402-2108

Mailing address

3004 Easton Ave
Chattanooga, TN 37415-5857
Phone (423) 661-4374

Other names 1

  • Alyse Flack Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191121002879 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668804154 Reassigns benefits to 2 organizations
I20230412002677 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668804154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Surgical, LLCGroup PAC ID 7911393509, 9 clinicians

Practice addresses (Care Compare)

1247 Riverfront Pkwy
Suite 100
Chattanooga, TN 37402-2108
Phone (423) 206-9000

2333 McCallie Ave
Chattanooga, TN 37404-3258
Phone (865) 546-8040

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2024 Accepting new patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 13, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Oct 1, 2024 Accepting new patients
Ams Anesthetist Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2024 Accepting new patients
Southeastern Surgical, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Chattanooga Endoscopy ASC LLC Past Accepting new patients

Locations

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

1247 Riverfront Pkwy
#100
Chattanooga, TN 37402
Phone (423) 206-9000

1247 Riverfront Pkwy
Ste 100
Chattanooga, TN 37402
Phone (423) 206-9000

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1570233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1134760630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 EASTON AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374155857",
            "telephone_number": "423-661-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 RIVERFRONT PKWY # 100",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022108",
            "telephone_number": "423-206-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "ALYSE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-05",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "26565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSE",
            "last_name": "FLACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 13, 2024; 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.