Amanda R Roark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

82957 Issued in TN

Practice address

601 Med Tech Pkwy
Johnson City, TN 37604-2253

Phone

(423) 610-1020

NPI assigned

Jan 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smokey Mountain Anesthesia PCGroup PAC ID 0749194363, 9 clinicians

Tennessee Valley Anesthesia Associates LLCGroup PAC ID 1254677222, 10 clinicians

Bright Night AnesthesiaGroup PAC ID 7517196819, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Bright Night Anesthesia

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
  • NPI 1427486430

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Smokey Mountain Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
  • NPI 1538196829

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Tennessee Valley Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
  • NPI 1053881706

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Advanced Anesthesia Solutions Inc.

  • Certified Registered Nurse Anesthetist
  • Bristol, TN
  • NPI 1164772109

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  Nurse Anesthetist, Certified Registered, TN

  Medicare reassignment NPD
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• American Anesthesiology Group of Tennessee, P. C.

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1114927738

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Meadowview ASC, LLC

  • Ambulatory Surgical Clinic/Center
  • Kingsport, TN
  • NPI 1629536826
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1386975738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 LARK ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048218",
            "telephone_number": "423-844-2686",
            "fax_number": "423-844-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042253",
            "telephone_number": "423-610-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207430",
            "country_code": "US",
            "telephone_number": "423-844-2686",
            "fax_number": "423-844-2688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARK",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "82957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Richard Risney, PA
• Madonna Samuel Riyad
• Roan Drug Company LLC
• Roan Drug Company LLC
• Lydia Pipes Roane, LCSW
• Ericka Roark
• Kaara Roark, FNP
• Shannon Marie Roark, MS, RDN, CLC
• Stephanie Shadden Roark, RD
• Christopher Robbins

• Certified Registered Nurse Anesthetist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.