Individual provider Active NPI

Matthew Wayne Milby, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1396144580
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
114281 Issued in OK
Practice address
2647 E 20TH St
Tulsa, OK 74104-5811
Phone
(901) 647-0609
NPI assigned
Aug 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 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 114281 OK Primary

Addresses

Primary practice location

2647 E 20TH St
Tulsa, OK 74104-5811

Mailing address

2647 E 20TH St
Tulsa, OK 74104-5811
Phone (901) 647-0609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151111000220 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981926698 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Promoting interoperability
98
Improvement activities
40
Cost
73.85

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jan 1, 2016 Accepting new patients
Medical Center Anesthesia Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2015 Accepting new patients
Henry County Medical Center Current Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2016 Accepting new patients
West Tennessee Healthcare Henry County Nurse Anesthetist, Certified Registered CurrentSince Aug 7, 2017 Accepting new patients
Henry County Medical Center CurrentSince Aug 7, 2017 Accepting new patients

Locations

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

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

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

1015 Kelley Dr
Ste 200
Paris, TN 38242
Phone (731) 644-2271

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/b673e6c7-c87b-498f-86b2-99b24c52c924/
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240001
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240000

Organizations & group practices 7

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1396144580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 E 20TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045811",
            "telephone_number": "901-647-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 E 20TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045811",
            "telephone_number": "901-647-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBY",
        "first_name": "MATTHEW",
        "middle_name": "WAYNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "114281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

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