Individual provider Active NPI

Matthew Lane Wilhaucks

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1255154894
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
227217 Issued in TN
Practice address
874 Union Ave RM 325
Memphis, TN 38103-3514
Phone
(901) 448-6128
NPI assigned
Nov 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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 227217 TN Primary

Addresses

Primary practice location

874 Union Ave RM 325
Memphis, TN 38103-3514

Mailing address

874 Union Ave RM 325
Memphis, TN 38103-3514

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250710002600 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507370418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Tennessee, HSC, College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
227217TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jun 25, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jun 25, 2025 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

6225 Humphreys Blvd
Memphis, TN 38120
Phone (901) 227-2727

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1255154894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 UNION AVE RM 325",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 UNION AVE RM 325",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033514",
            "telephone_number": "901-448-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHAUCKS",
        "first_name": "MATTHEW",
        "middle_name": "LANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-04",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "227217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.