Individual provider Active NPI

Amy Catherine Demaree Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Collegedale, TN
National Provider Identifier
1235453721
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.11444-NA Issued in OH
Practice address
5588 Tucker Rd
Department of Surgery
Collegedale, TN 37315-1396
Phone
(423) 504-5669
Fax
(419) 783-4416
NPI assigned
Mar 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN0000014687 TN
Certified Registered Nurse Anesthetist 367500000X 6372A KY
Certified Registered Nurse Anesthetist 367500000X RN188003 GA
Certified Registered Nurse Anesthetist 367500000X COA.11444-NA OH Primary

Addresses

Primary practice location

5588 Tucker Rd
Department of Surgery
Collegedale, TN 37315-1396

Mailing address

PO Box 1355
5588 Tucker Rd
Collegedale, TN 37315-1355
Phone (423) 504-5669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130430000263 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103008677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redmond Anesthesia and Pain Treatment, PCGroup PAC ID 4880841741, 77 clinicians

Practice addresses (Care Compare)

501 Redmond Rd NW
Rome, GA 30165-1415
Phone (706) 291-0291

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
6372AKYMDCertified Registered Nurse Anesthetist
COA.11444-NAOHMDCertified Registered Nurse Anesthetist
APN0000014687TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Anesthesia Billing Services, LLC CurrentSince Sep 8, 2014 Accepting new patients
Redmond Anesthesia and Pain Treatment, PC Nurse Anesthetist, Certified Registered CurrentSince Mar 16, 2015 Accepting new patients
Kentucky River HBP LLC Past Accepting new patients
Chattanooga Endoscopy ASC LLC Past Accepting new patients
Obleness Anesthesia Billing LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705
Phone (706) 517-2050

16 John Maddox Dr NW
Rome, GA 30165
Phone (706) 234-0315

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

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.

Hospital & facility affiliations 2

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": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1235453721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1355",
            "address_2": "5588 TUCKER RD",
            "city": "COLLEGEDALE",
            "state": "TN",
            "postal_code": "373151355",
            "telephone_number": "423-504-5669",
            "fax_number": "423-504-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5588 TUCKER RD",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "COLLEGEDALE",
            "state": "TN",
            "postal_code": "373151396",
            "telephone_number": "423-504-5669",
            "fax_number": "419-783-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AMY",
        "middle_name": "CATHERINE DEMAREE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-26",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000014687",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "6372A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN188003",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.11444-NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegedale, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.