Individual provider Active NPI

Abigail Taylor Coulthard

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1366134033
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
34696 Issued in TN
Practice address
2525 Desales Ave
Chattanooga, TN 37404-1161
Phone
(423) 495-2525
NPI assigned
May 22, 2023
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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 221978 TN
Certified Registered Nurse Anesthetist 367500000X 34696 TN Primary

Addresses

Primary practice location

2525 Desales Ave
Chattanooga, TN 37404-1161

Mailing address

288 Cottonwood BND NW
Cleveland, TN 37312-1742
Phone (423) 298-4473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230928002399 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870947534 Reassigns benefits to 2 organizations
I20260402003414 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870947534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525

4710 Battlefield Pkwy
Ringgold, GA 30736-5164
Phone (423) 495-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
221978TNMDRegistered Nurse
34696TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Sep 7, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Sep 7, 2023 Accepting new patients
Memorial Health Partners Foundation Inc CurrentSince Jul 1, 2024 Accepting new patients
Memorial Health Partners Foundation, Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

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

Organizations & group practices 4

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 2

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1366134033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 COTTONWOOD BND NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373121742",
            "telephone_number": "423-298-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-495-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTHARD",
        "first_name": "ABIGAIL",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "221978",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "34696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.