NPIMap

Organization Active NPI

Wellmont Health System Bristol Crna Professional Group

  • Certified Registered Nurse Anesthetist
  • Bristol, TN
National Provider Identifier
1235146127
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
WELLMONT HEALTH SYSTEM BRISTOL CRNA PROFESSIONAL GROUP
Practice address
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone
(423) 844-1121
NPI assigned
Aug 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Renee D Dixon, CRNANPI 1699975623
Title
Chief Crna
Phone
(423) 968-4540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

1 Medical Park Blvd
Bristol, TN 37620-7430

Mailing address

350 Blountville Hwy
Suite 207
Bristol, TN 37620-0213
Phone (423) 968-4540

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235146127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY",
            "address_2": "SUITE 207",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200213",
            "telephone_number": "423-968-4540",
            "fax_number": "423-968-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMONT HEALTH SYSTEM BRISTOL CRNA PROFESSIONAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF CRNA",
        "authorized_official_telephone_number": "423-968-4540",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.