Individual provider Active NPI

Linda H Stamm, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
National Provider Identifier
1386637452
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN0000147508 Issued in TN
Practice address
1009 Lark St
Suite 2
Johnson City, TN 37604-8217
Phone
(423) 283-0776
Fax
(423) 283-0549
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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 RN0000147508 TN Primary

Addresses

Primary practice location

1009 Lark St
Suite 2
Johnson City, TN 37604-8217

Mailing address

PO Box 3727
Johnson City, TN 37602-3727
Phone (423) 283-0776

Other identifiers 1

IdentifierTypeStateIssuer
3634538MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CA, OR, HI4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20050215001111 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789636937
I20171207000154 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789636937 Reassigns benefits to 1 organization
I20190711001968 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789636937 Reassigns benefits to 1 organization
I20240829003631 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789636937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sda Services of CaGroup PAC ID 5496094823, 68 clinicians

Practice addresses (Care Compare)

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN0000147508TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia Hawaii, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 16, 2024 Accepting new patients
Sda Services of Ca CurrentSince Jan 1, 2019 Accepting new patients
North Bend Medical Center Inc CurrentSince Aug 1, 2019 Accepting new patients
Rem Anesthesia Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3800 Janes Rd
Arcata, CA 95521
Phone (707) 822-3621

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

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 and National Provider Directory roles.

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400112000000",
    "number": "1386637452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3727",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023727",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 LARK ST",
            "address_2": "SUITE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048217",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMM",
        "first_name": "LINDA",
        "middle_name": "H",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000147508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3634538",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.