Individual provider Active NPI

Davelin Woodard

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1295477941
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN0000031880 Issued in TN
Practice address
6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone
(901) 226-5000
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 APN0000031880 TN Primary

Addresses

Primary practice location

6019 Walnut Grove Rd
Memphis, TN 38120-2113

Mailing address

1839 Madison Ave Apt 507
Memphis, TN 38104-2799
Phone (662) 816-7113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707000955 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597145680 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000031880TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jun 22, 2022 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2022 Accepting new patients

Locations

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

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295477941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 MADISON AVE APT 507",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042799",
            "telephone_number": "662-816-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 WALNUT GROVE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202113",
            "telephone_number": "901-226-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "DAVELIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000031880",
            "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 Jul 21, 2022; 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.

Verify at the official NPI Registry.