Individual provider Active NPI

Mark Amonett, CRNA

  • Certified Registered Nurse Anesthetist
  • Nashville, TN
National Provider Identifier
1194724757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN0000010560 Issued in TN
Practice address
1310 24TH Ave South
Nashville, TN 37212-2637
Phone
(615) 327-5390
Fax
(615) 321-6359
NPI assigned
Jul 18, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 049658 TN
Certified Registered Nurse Anesthetist 367500000X APN0000010560 TN Primary

Addresses

Primary practice location

1310 24TH Ave South
Nashville, TN 37212-2637

Mailing address

1301 Stratford Ave
Nashville, TN 37216
Phone (615) 226-5047

Other identifiers 2

IdentifierTypeStateIssuer
3627617MedicaidTN
3111785OtherTNBCBS NUMBER

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

State licenses

LicenseStateTypeSpecialty
049658TNMDCertified Registered Nurse Anesthetist
APN0000010560TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Novamed Management Services LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Novamed Management Services LLC Past Accepting new patients

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, 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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194724757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 STRATFORD AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37216",
            "telephone_number": "615-226-5047",
            "fax_number": "615-321-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE SOUTH",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "telephone_number": "615-327-5390",
            "fax_number": "615-321-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMONETT",
        "first_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "049658",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000010560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3627617",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "3111785",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, 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.

Verify at the official NPI Registry.