Individual provider Active NPI

Madison Shipley Powers

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
National Provider Identifier
1215633631
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
40811 Issued in TN
Practice address
10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone
(423) 390-0451
NPI assigned
Feb 7, 2023
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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 40811 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

10415 Wallace Alley St
Kingsport, TN 37663-3936

Mailing address

6385 Bristol Hwy Apt 250
Piney Flats, TN 37686-5235
Phone (423) 483-4540

Other practice location 1

6385 Bristol Hwy Apt 250
Piney Flats, TN 37686-5235
Phone (423) 483-4540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260209000185 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830678085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Virginia Commonwealth University, School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 390-0451

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40811TNMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Dec 28, 2025 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Dec 28, 2025 Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

10415 Wallace Alley St
Kingsport, TN 37663
Phone 4233900451 ext. 00451

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.

Hospital & facility affiliations 3

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": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1215633631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 BRISTOL HWY APT 250",
            "city": "PINEY FLATS",
            "state": "TN",
            "postal_code": "376865235",
            "telephone_number": "423-483-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-390-0451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6385 Bristol Hwy Apt 250",
            "address_purpose": "LOCATION",
            "city": "Piney Flats",
            "state": "TN",
            "postal_code": "376865235",
            "country_code": "US",
            "telephone_number": "423-483-4540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWERS",
        "first_name": "MADISON",
        "middle_name": "SHIPLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "40811",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 15, 2026; 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.