Individual provider Active NPI

David Perkins, CRNA

  • Certified Registered Nurse Anesthetist
  • Germantown, TN
National Provider Identifier
1336191642
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN 11086 Issued in TN
Practice address
1900 Exeter Rd
Suite 210
Germantown, TN 38138-2954
Phone
(901) 818-2160
Fax
(901) 682-9522
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 108924 TN
Certified Registered Nurse Anesthetist 367500000X APN 11086 TN Primary

Addresses

Primary practice location

1900 Exeter Rd
Suite 210
Germantown, TN 38138-2954

Mailing address

1900 Exeter Rd
Suite 210
Germantown, TN 38138-2954
Phone (901) 818-2160

Other identifiers 6

IdentifierTypeStateIssuer
430074164OtherTNRAILROAD MEDICARE
0126209MedicaidMS
146866701MedicaidAR
99511OtherARBLUE CROSS
3630312MedicaidTN
4037284OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52786TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of Memphis, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 1

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1336191642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 EXETER RD",
            "address_2": "SUITE 210",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382954",
            "telephone_number": "901-818-2160",
            "fax_number": "901-682-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 EXETER RD",
            "address_2": "SUITE 210",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382954",
            "telephone_number": "901-818-2160",
            "fax_number": "901-682-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN 108924",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN 11086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430074164",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126209",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146866701",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "99511",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3630312",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4037284",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.