Individual provider Active NPI

Amber Lynn Stafford, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
National Provider Identifier
1295981496
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
13597 Issued in TN
Practice address
708 W Forest Ave
Jackson, TN 38301-3901
Phone
(731) 541-7070
NPI assigned
Aug 7, 2008
Last updated
Nov 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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 13597 TN Primary

Addresses

Primary practice location

708 W Forest Ave
Jackson, TN 38301-3901

Mailing address

410 N Cedar Bluff Rd
Ste 300
Knoxville, TN 37923-3632
Phone (865) 342-8900

Other names 1

  • Amber Mathis Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000331 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193883908 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Anesthesia, IncGroup PAC ID 2769629187, 107 clinicians

Practice addresses (Care Compare)

301 Tyson Ave
Paris, TN 38242-4544
Phone (731) 642-1220

400 E Tickle St
Dyersburg, TN 38024-3120
Phone (731) 285-2410

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.74 of 100Reported as group
Quality
65.48
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13597TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry County Medical Center Current Accepting new patients
West Tennessee Healthcare Henry County Nurse Anesthetist, Certified Registered CurrentSince May 15, 2016 Accepting new patients
Medical Center Anesthesia Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 6, 2013 Accepting new patients
West Tennessee Healthcare Henry County CurrentSince Jun 13, 2025 Accepting new patients
Henry County Medical Center CurrentSince May 15, 2016 Accepting new patients
Northstar Anesthesia of Tennessee, PLLC CurrentSince Apr 1, 2015 Accepting new patients
Lifelinc Anesthesia II, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients

Locations

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

1015 Kelley Dr
Ste 200
Paris, TN 38242
Phone (731) 644-2271

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240000
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240001
  • FHIR API: https://fhir-myrecord.cerner.com/r4/b673e6c7-c87b-498f-86b2-99b24c52c924/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1295981496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N CEDAR BLUFF RD",
            "address_2": "STE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379233632",
            "telephone_number": "865-342-8900",
            "fax_number": "865-691-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W FOREST AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013901",
            "telephone_number": "731-541-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "AMBER",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "13597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "MATHIS",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.