Bryan T Affolter, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Chattanooga, TN

NPI 1265407134 · NPPES record last updated Aug 27, 2008

Key facts

NPI
1265407134
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
APN11209 (TN)
Practice address
924 Spring Creek Rd
Chattanooga, TN 37412-3910
Phone
(423) 899-1600
Fax
(423) 899-2171
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Surgery Center of Chattanooga LLC (2 clinicians)

Practice addresses (Care Compare)

924 Spring Creek Rd
Chattanooga, TN 37412-3910
Phone (423) 899-1600

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TN, GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050405000265 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830146679 Reassigns benefits to 2 organizations
I20190817000444 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830146679 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN153379GAMDCertified Registered Nurse Anesthetist
APN11209TNMDCertified Registered Nurse Anesthetist
RN102072TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Surgery Center of Chattanooga, LLC Current
since May 9, 2008
Accepting new patients
Physicians Surgery Center of Chattanooga, LLC Current Accepting new patients
Physicians Surgery Center of Chattanooga, LLC Nurse Anesthetist, Certified Registered Current
since May 9, 2008
Accepting new patients
Earley Daze Anesthesia LLC Nurse Anesthetist, Certified Registered Current
since Jun 1, 2019
Accepting new patients
Amsurg Chattanooga Anesthesia LLC Current
since Sep 28, 2015
Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients
Chattanooga Endoscopy ASC LLC Past Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1111 Professional Blvd
Dalton, GA 30720
Phone (404) 226-2232

5751 Uptain Rd
Ste 100
Chattanooga, TN 37411
Phone (423) 855-8406

2341 McCallie Ave
Ste 303
Chattanooga, TN 37404
Phone (423) 696-3999

1501 Riverside Dr
Ste 117
Chattanooga, TN 37406
Phone (423) 648-0576

924 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 629-7688

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN11209 TN Yes
Certified Registered Nurse Anesthetist 367500000X RN102072 TN
Certified Registered Nurse Anesthetist 367500000X RN153379 GA

Addresses

Primary practice location

924 Spring Creek Rd
Chattanooga, TN 37412-3910

Mailing address

PO Box 11114
Chattanooga, TN 37401-2114
Phone (423) 899-1600

Other identifiers

IdentifierTypeStateIssuer
3141447OtherTNBCBS
3629459MedicaidTN

Other providers in Chattanooga, TN

All providers in Chattanooga, TN · Certified Registered Nurse Anesthetist in Tennessee

Sources for this page

Verify at the official NPI Registry.