Individual provider Active NPI

Virginia Lane Kelly, CRNA

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
National Provider Identifier
1184619306
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
14631 Issued in TN
Practice address
2121 Medical Centre Way
Suite 100
Knoxville, TN 37920
Phone
(606) 337-3051
Fax
(606) 337-2871
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1072826/4024A KY
Certified Registered Nurse Anesthetist 367500000X 14631 TN Primary

Addresses

Primary practice location

2121 Medical Centre Way
Suite 100
Knoxville, TN 37920

Mailing address

9000 Executive Park Drive - Upa Physicians
C200
Knoxville, TN 37923
Phone (865) 670-6700

Other identifiers 3

IdentifierTypeStateIssuer
74006362MedicaidKY
000000276584OtherANTHEM BC&BS
P00078424OtherKYRAILROAD MEDICARE

Other names 1

  • Virginia Lane Evans Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100106000410 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951332584 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group of Knoxville PLLC 4 clinicians
American Anesthesiology of Tennessee PC 296 clinicians

Practice addresses (Care Compare)

1128 E Weisgarber Rd
Suite 100
Knoxville, TN 37909-2677
Phone (865) 251-5215

7565 Dannaher Dr
Powell, TN 37849-4029
Phone (865) 546-8040

Hospital & facility affiliations

  • Physicians Regional Medical Center Hospital, Powell, TN, CCN 440120

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4024KYMDSocial Worker
1072826/4024AKYMDCertified Registered Nurse Anesthetist
14631TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Dec 21, 2009 Accepting new patients
University Anesthesiologists, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 19, 2022 Accepting new patients
Anesthesia Group of Knoxville PLLC CurrentSince Jan 18, 2025 Accepting new patients
Knoxville Spine Surgery LLC Current Accepting new patients
University Anesthesiologists, PLLC Past Accepting new patients

Locations

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

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

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

1128 E Weisgarber Rd
Ste 100
Knoxville, TN 37909
Phone (865) 251-5215

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

Organizations & group practices 5

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1184619306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 EXECUTIVE PARK DRIVE - UPA PHYSICIANS",
            "address_2": "C200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37923",
            "telephone_number": "865-670-6700",
            "fax_number": "865-670-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 MEDICAL CENTRE WAY",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37920",
            "telephone_number": "606-337-3051",
            "fax_number": "606-337-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "VIRGINIA",
        "middle_name": "LANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1072826/4024A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "14631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74006362",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC&BS",
            "identifier": "000000276584",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00078424",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "EVANS",
            "middle_name": "LANE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 26, 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.