Individual provider Active NPI

Mary Sandra Lathrem, CRNA

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
National Provider Identifier
1306248604
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
38874 Issued in TN
Practice address
256 Fort Sanders West Blvd
Knoxville, TN 37922-3355
Phone
(859) 699-9534
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3008752 KY
Certified Registered Nurse Anesthetist 367500000X APRN9284688 FL
Certified Registered Nurse Anesthetist 367500000X 38874 TN Primary

Addresses

Primary practice location

256 Fort Sanders West Blvd
Knoxville, TN 37922-3355

Mailing address

940 Bob Kirby Rd
Knoxville, TN 37923-1910
Phone (859) 699-9534

Other practice location 1

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

Other practice location 2

1916 James Downey Rd
Independence, MO 64057-1054
Phone (859) 699-9534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL, TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20141106000448 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496977464 Reassigns benefits to 1 organization
I20170417001773 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496977464 Reassigns benefits to 6 organizations
I20251014000365 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496977464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Anesthesia Associates LLCGroup PAC ID 7517231186, 43 clinicians
American Anesthesiology of Tennessee PCGroup PAC ID 9931001922, 296 clinicians

Practice addresses (Care Compare)

13051 University Dr
Suite 102
Fort Myers, FL 33907-5704
Phone (239) 887-3608

140 Capital Dr
Suite 2
Knoxville, TN 37922-3572
Phone (865) 546-8040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38874TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Oct 1, 2025 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 21, 2022 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2025 Accepting new patients
Ams Anesthetist Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2025 Accepting new patients
Orlando Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Sep 24, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2023 Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Highlands Anesthesia LLC PastSince Aug 1, 2017 Accepting new patients

Locations

1920 Don Wickham Dr
Clermont, FL 34711
Phone (352) 243-5891

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

201 Mohawk Rd
Minneola, FL 34715
Phone (973) 979-9079

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

88 W Kaley St
Orlando, FL 32806
Phone (407) 423-0573

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

62 Columbia St
Orlando, FL 32806
Phone (321) 214-4903

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

540 Jett Dr
Jackson, KY 41339
Phone (606) 666-4971

2485 Highway 644
Louisa, KY 41230
Phone (606) 638-1154

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

256 Fort Sanders West Blvd
Knoxville, TN 37922
Phone (865) 244-4580

140 Capital Dr
Ste 2
Knoxville, TN 37922
Phone (865) 251-0338

Organizations & group practices 12

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1306248604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BOB KIRBY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379231910",
            "telephone_number": "859-699-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 FORT SANDERS WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223355",
            "telephone_number": "859-699-9534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Columbia St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061115",
            "country_code": "US",
            "telephone_number": "321-843-5851",
            "fax_number": "321-843-1673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1916 James Downey Rd",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640571054",
            "country_code": "US",
            "telephone_number": "859-699-9534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHREM",
        "first_name": "MARY",
        "middle_name": "SANDRA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3008752",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9284688",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "38874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.