Individual provider Active NPI

Carly Cundiff

  • Certified Registered Nurse Anesthetist
  • Murfreesboro, TN
National Provider Identifier
1336786177
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26933 Issued in TN
Practice address
1800 Medical Center Pkwy Ste 330
Murfreesboro, TN 37129-2586
Phone
(615) 396-4464
NPI assigned
Nov 27, 2019
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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 26933 TN Primary

Addresses

Primary practice location

1800 Medical Center Pkwy Ste 330
Murfreesboro, TN 37129-2586

Mailing address

PO Box 1252
Murfreesboro, TN 37133-1252
Phone (615) 396-4464

Other practice location 1

605 N Willow Ave
Cookeville, TN 38501-1717
Phone (615) 962-5745

Other practice location 2

1700 Medical Center Pkwy
Murfreesboro, TN 37129-2245
Phone (615) 396-4100

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Bailey Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200224000405 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597192005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murfreesboro Anesthesia Group, P.a.Group PAC ID 9335038868, 61 clinicians

Practice addresses (Care Compare)

1800 Medical Ctr Pkwy
Suite 330
Murfreesboro, TN 37129-2568
Phone (615) 410-7873

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26933TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Anesthesia Group, P.a. Nurse Anesthetist, Certified Registered CurrentSince Jan 9, 2020 Accepting new patients

Locations

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

1800 Medical Center Pkwy
Ste 330
Murfreesboro, TN 37129
Phone (615) 396-4464

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1336786177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1252",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371331252",
            "telephone_number": "615-396-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER PKWY STE 330",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292586",
            "telephone_number": "615-396-4464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 N Willow Ave",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385011717",
            "country_code": "US",
            "telephone_number": "615-962-5745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292245",
            "country_code": "US",
            "telephone_number": "615-396-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNDIFF",
        "first_name": "CARLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "26933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Bailey",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 Medical Center Pkwy",
            "city": "Murfreesboro",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371292245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.