Individual provider Active NPI

Charles Weeden, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1366480196
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
139391 Issued in TN
Practice address
1755 Kirby Pkwy
Memphis, TN 38120-4398
Phone
(901) 725-5846
Fax
(901) 726-4827
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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 139391 TN Primary

Addresses

Primary practice location

1755 Kirby Pkwy
Memphis, TN 38120-4398

Mailing address

PO Box 171306
Memphis, TN 38187-1306
Phone (901) 725-5846

Other identifiers 3

IdentifierTypeStateIssuer
09454865MedicaidMS
4058266OtherTNBLUE CROSS
3632659MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111110000685 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729252655 Reassigns benefits to 3 organizations
I20260626001480 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729252655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midsouth Speciality Anesthesia Services LLCGroup PAC ID 6103293667, 29 clinicians

Practice addresses (Care Compare)

1750 Madison Ave
Suite 300
Memphis, TN 38104-6428
Phone (901) 390-2930

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
83.24
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Anesthesia Group, PA CurrentSince Mar 15, 2003 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Mar 20, 2024 Accepting new patients
Midsouth Speciality Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2024 Accepting new patients
American Anesthesiology of Mississippi LLC Past Accepting new patients

Locations

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

1355 W Brierbrook Rd
Germantown, TN 38138
Phone (901) 755-8300

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

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000

1750 Madison Ave
Ste 300
Memphis, TN 38104
Phone (901) 725-7025

6225 Humphreys Blvd
Memphis, TN 38120
Phone (901) 227-2727

6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

1044 Cresthaven Rd
Memphis, TN 38119
Phone (662) 470-5029

3301 S 14th St
Ste 16180
Abilene, TX 79605

Organizations & group practices 6

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1366480196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171306",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381871306",
            "telephone_number": "901-725-5846",
            "fax_number": "901-726-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 KIRBY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204398",
            "telephone_number": "901-725-5846",
            "fax_number": "901-726-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEDEN",
        "first_name": "CHARLES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "139391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09454865",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4058266",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3632659",
            "state": "TN"
        }
    ],
    "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 Aug 28, 2007; 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.