Individual provider Active NPI

Hannah Morgan Lutz, CRNA

  • Certified Registered Nurse Anesthetist
  • Clarksville, AR
National Provider Identifier
1225877145
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148025 Issued in AR
Practice address
1100 E Poplar St
Clarksville, AR 72830-4419
Phone
(479) 754-5454
NPI assigned
May 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R107107 AR
Certified Registered Nurse Anesthetist 367500000X 148025 AR Primary

Addresses

Primary practice location

1100 E Poplar St
Clarksville, AR 72830-4419

Mailing address

11456 Highway 21
Clarksville, AR 72830-6524
Phone (479) 567-0309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240622000545 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880137579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson Regional Medical CenterGroup PAC ID 1658360284, 16 clinicians

Practice addresses (Care Compare)

1100 E Poplar St B
JRMC Anesthesia
Clarksville, AR 72830-4419
Phone (479) 754-5454

Hospital & facility affiliations

  • Johnson Regional Medical Center Hospital, Clarksville, AR, CCN 040002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R107107ARMDRegistered Nurse
148025ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Regional Medical Center CurrentSince Jun 6, 2024 Accepting new patients
Johnson Regional Medical Center CurrentSince Jun 6, 2024 Accepting new patients

Locations

1100 E Poplar St
Clarksville, AR 72830
Phone (479) 754-5393

1100 E Poplar St
Ste B
Clarksville, AR 72830
Phone (479) 754-5454

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.

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": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1225877145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11456 HIGHWAY 21",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728306524",
            "telephone_number": "479-567-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E POPLAR ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728304419",
            "telephone_number": "479-754-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "HANNAH",
        "middle_name": "MORGAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R107107",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "148025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.