Active NPI
Mikki S Brown, CRNA
- Certified Registered Nurse Anesthetist
- Kingsport, TN
National Provider Identifier
1164416137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 9533
- Practice address
- 135 W Ravine Rd
Ste 5-B
Kingsport, TN 37660-3847 - Phone
- (423) 224-3460
- Fax
- (423) 224-3465
- NPI assigned
- Sep 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 9533 | TN | Primary |
Addresses
Primary practice location
135 W Ravine Rd
Ste 5-B
Kingsport, TN 37660-3847
Mailing address
PO Box 1308
Kingsport, TN 37662-1308
Phone (423) 224-3460
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74346818 | Medicaid | KY | |
| 00013859 | Other | NHC CARE ADMINISTRATORS | |
| 3607743 | Medicaid | TN | |
| 3046113 | Other | BLUE SHIELD OF TN | |
| 0221910000 | Medicaid | WV | |
| 261963 | Other | ANTHEM BCBS | |
| TN0100 | Other | JOHN DEERE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9533 | TN | MD | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology Group of Tennessee, P. C. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Kingsport, TN
- NPI 1114927738
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164416137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1308",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376621308",
"telephone_number": "423-224-3460",
"fax_number": "423-224-3465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 W RAVINE RD",
"address_2": "STE 5-B",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603847",
"telephone_number": "423-224-3460",
"fax_number": "423-224-3465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MIKKI",
"middle_name": "S",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "9533",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74346818",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHC CARE ADMINISTRATORS",
"identifier": "00013859",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3607743",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF TN",
"identifier": "3046113",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0221910000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "261963",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN0100",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.