Active NPI
Mary K King, CRNA
- Certified Registered Nurse Anesthetist
- Bristol, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 47793
- Practice address
- 1 Medical Park Blvd
Bristol, TN 37620-7430 - Phone
- (423) 844-1121
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 47793 | TN | Primary |
Addresses
Primary practice location
1 Medical Park Blvd
Bristol, TN 37620-7430
Mailing address
105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070828000081 | TN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4587756150 | Reassigns benefits to 3 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47793 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Tennessee Ambulatory Surgery Center LLC | Current | Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Innovative Surgical Solutions, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| Bristol Ambulatory Surgery Center, LLC | Current | Accepting new patients | |
| Paragon Anesthesia PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Singing River Health System | Past | Accepting new patients |
Locations
1159 Volunteer Pkwy
Ste C3
Bristol, TN 37620
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
350 Blountville Hwy
Ste 108
Bristol, TN 37620
Phone (423) 844-6120
3185 W State St
Bristol, TN 37620
Phone (423) 968-4141
3185 W State St
Ste 2020
Bristol, TN 37620
Phone (423) 968-4141
1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000
10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150
105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220
Organizations & group practices 8
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.
-
- Certified Registered Nurse Anesthetist
- Bristol, TN
- NPI 1437713971
Nurse Anesthetist, Certified Registered, TN
-
- Anesthesiology Physician
- Kingsport, TN
- NPI 1538174974
Nurse Anesthetist, Certified Registered, TN
-
- Ambulatory Surgical Clinic/Center
- Bristol, TN
- NPI 1790344182
-
- Ambulatory Surgical Clinic/Center
- Johnson City, TN
- NPI 1659360071
-
- Psychiatry Physician
- Johnson City, TN
- NPI 1275393522
-
- Urgent Care Clinic/Center
- Bristol, TN
- NPI 1770942575
-
- Internal Medicine Physician
- Pascagoula, MS
- NPI 1134283419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1245268481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 W STONE DR",
"address_2": "SUITE 6A",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603365",
"telephone_number": "423-408-7220",
"fax_number": "423-408-7405"
},
{
"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": {
"last_name": "KING",
"first_name": "MARY",
"middle_name": "K",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "47793",
"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 Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.