Individual provider Active NPI

Teresa F Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1346577673
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
14328 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 448-5893
Fax
(901) 448-5540
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 122993 TN
Certified Registered Nurse Anesthetist 367500000X 14328 TN Primary

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

877 Jefferson Ave
Attn: Provider Enrollment
Memphis, TN 38103-2807
Phone (901) 448-5893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100223000372 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628112075 Reassigns benefits to 2 organizations
I20130925000468 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628112075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia VIII PLLCGroup PAC ID 3173984762, 155 clinicians

Practice addresses (Care Compare)

435 2ND St
Newport, TN 37821-3703
Phone (423) 625-2200

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
122993TNMDCertified Registered Nurse Anesthetist
14328TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelinc Anesthesia II, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 11, 2023 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 29, 2026 Accepting new patients
Lifelinc Anesthesia VIII PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2024 Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

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

Organizations & group practices 3

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": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1346577673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-448-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-448-5893",
            "fax_number": "901-448-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TERESA",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "122993",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "14328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.