Individual provider Active NPI

Matthew Kovach

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
National Provider Identifier
1174038376
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
23708 Issued in TN
Practice address
1924 Alcoa Highway
Knoxville, TN 37920
Phone
(865) 305-9000
NPI assigned
Dec 11, 2017
Last updated
Jul 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 23708 TN Primary
Certified Registered Nurse Anesthetist 367500000X 118544 OH
Certified Registered Nurse Anesthetist 367500000X 118544 TN

Addresses

Primary practice location

1924 Alcoa Highway
Knoxville, TN 37920

Mailing address

5711 Theota Ave
Parma, OH 44129-2239

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180719003008 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224385380 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Anesthesia Associates PCGroup PAC ID 9335296466, 6 clinicians

Practice addresses (Care Compare)

1706 E Lamar Alexander Pkwy
Maryville, TN 37804-6204
Phone (865) 983-0073

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118544OHMDCertified Registered Nurse Anesthetist
118544TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince May 1, 2025 Accepting new patients
University Anesthesiologists, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2018 Accepting new patients
Foothills Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2024 Accepting new patients
University Anesthesiologists, PLLC PastSince Mar 1, 2018 Accepting new patients

Locations

1600 Accelerator Way
Ste 100
Knoxville, TN 37920
Phone (865) 264-3404

1924 Alcoa Hwy
#U109
Knoxville, TN 37920
Phone (865) 305-9220

256 Fort Sanders West Blvd
Knoxville, TN 37922
Phone (865) 244-4580

550 Fort Loudon Medical Center Dr
#C
Lenoir City, TN 37772

1706 E Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 983-0073

Organizations & group practices 4

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": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1174038376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5711 THEOTA AVE",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441292239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HIGHWAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37920",
            "telephone_number": "865-305-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACH",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-11",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "23708",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "118544",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "118544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.