Individual provider Active NPI

Harry Glenn Lannom, CRNA

  • Certified Registered Nurse Anesthetist
  • Murfreesboro, TN
National Provider Identifier
1174577696
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN105174 Issued in TN
Practice address
1800 Medical Center Pkwy
Suite 330
Murfreesboro, TN 37129-2567
Phone
(615) 396-4464
Fax
(615) 396-6748
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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 RN105174 TN Primary

Addresses

Primary practice location

1800 Medical Center Pkwy
Suite 330
Murfreesboro, TN 37129-2567

Mailing address

PO Box 1252
Murfreesboro, TN 37133-1252
Phone (615) 396-4464

Other identifiers 4

IdentifierTypeStateIssuer
4182581OtherTNBCBS EFFECTIVE 5/1/08
430052095OtherTNRR MEDICARE
3144083OtherTNBLUE CROSS BLUE SHIELD
3628616MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111219000832 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234304395 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN105174TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Anesthesia Group, P.a. Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 1999 Accepting new patients
Anesthesia Care of Tullahoma, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1800 Medical Center Pkwy
Ste 330
Murfreesboro, TN 37129
Phone (615) 396-4464

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1174577696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1252",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371331252",
            "telephone_number": "615-396-4464",
            "fax_number": "615-396-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER PKWY",
            "address_2": "SUITE 330",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292567",
            "telephone_number": "615-396-4464",
            "fax_number": "615-396-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANNOM",
        "first_name": "HARRY",
        "middle_name": "GLENN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN105174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFFECTIVE 5/1/08",
            "identifier": "4182581",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "430052095",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3144083",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3628616",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.