Individual provider Active NPI

Calan Ray Fuqua, CRNA

  • Certified Registered Nurse Anesthetist
  • Madison, TN
National Provider Identifier
1164191144
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
30987 Issued in TN
Practice address
315 Hospital Dr
Madison, TN 37115-5030
Phone
(615) 732-7671
NPI assigned
Sep 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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 205185 TN
Certified Registered Nurse Anesthetist 367500000X 30987 TN Primary

Addresses

Primary practice location

315 Hospital Dr
Madison, TN 37115-5030

Mailing address

1412 Beech Hollow CT
Nashville, TN 37211-8639
Phone (615) 389-6626

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220131000930 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880087600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group, P.C.Group PAC ID 6901702307, 439 clinicians

Practice addresses (Care Compare)

110 29TH Ave N
Suite 202
Nashville, TN 37203-1448
Phone (615) 327-4304

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.57 of 100Reported as group
Quality
59.49
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
205185TNMDRegistered Nurse
30987TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Anesthesia of Tennessee CurrentSince Mar 1, 2026 Accepting new patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered CurrentSince Mar 14, 2022 Accepting new patients

Locations

110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870

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 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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1164191144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 BEECH HOLLOW CT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118639",
            "telephone_number": "615-389-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOSPITAL DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155030",
            "telephone_number": "615-732-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "CALAN",
        "middle_name": "RAY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "205185",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "30987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.