NPIMap

Organization Active NPI

Genesis Anesthesia Services, PLLC

  • Certified Registered Nurse Anesthetist
  • Cookeville, TN
National Provider Identifier
1316236367
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GENESIS ANESTHESIA SERVICES, PLLC
Practice address
1059 Neal St
Suite B
Cookeville, TN 38501-0946
Phone
(615) 620-2320
Fax
(615) 620-2323
NPI assigned
Mar 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

Name
Robert A Hamilton, CRNANPI 1073589305
Title
Owner
Phone
(615) 620-2320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1059 Neal St
Suite B
Cookeville, TN 38501-0946

Mailing address

PO Box 291264
Nashville, TN 37229-1264
Phone (615) 620-2320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110418000529 TN Part B Supplier - Clinic/Group Practice 2264616101 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
Practice locations: Cookeville, TN; Goodlettsville, TN; Nashville, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Genesis Anesthesia Services PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

79 Fairfield Blvd
Crossville, TN 38558
Phone (931) 484-3344

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1316236367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291264",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372291264",
            "telephone_number": "615-620-2320",
            "fax_number": "615-620-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 NEAL ST",
            "address_2": "SUITE B",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010946",
            "telephone_number": "615-620-2320",
            "fax_number": "615-620-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS ANESTHESIA SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-620-2320",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.