Individual provider Active NPI

Seth Patrick Duty, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
National Provider Identifier
1225498223
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
20979 Issued in TN
Practice address
1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone
(423) 283-0776
Fax
(423) 283-0549
NPI assigned
Mar 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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 20979 TN Primary

Addresses

Primary practice location

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237

Mailing address

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidTN

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
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Tennessee Valley Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2022 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Jul 22, 2022 Accepting new patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jul 22, 2022 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

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

310 N State of Franklin Rd
Ste 202
Johnson City, TN 37604
Phone (423) 434-3700

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

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.

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1225498223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 NOVUS DR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048237",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 NOVUS DR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048237",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTY",
        "first_name": "SETH",
        "middle_name": "PATRICK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-03",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "20979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.