South Fork Anesthesia Associates, PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

SOUTH FORK ANESTHESIA ASSOCIATES, PLLC

Practice address

107 Quail Ridge Way
Jonesborough, TN 37659-4166

Phone

(865) 310-6371

NPI assigned

Apr 29, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Kevin C Jessee, CRNA

Title

Owner

Phone

(865) 310-6371

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1427631290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BROWNS MILL RD STE 6-207",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044100",
            "telephone_number": "423-758-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 QUAIL RIDGE WAY",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376594166",
            "telephone_number": "865-310-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FORK ANESTHESIA ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "JESSEE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-310-6371",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Michael Smagula, MD
• Brandy Leshea Smart
• Lydia Abigail Smith, RDN, LDN
• Madison D Smith, MA
• Angela M Snyder, FNP-C
• Stay Aligned Chiropractic, Inc.
• Michael Amos Stepp, PHARMACIST
• Ashley Paige Stinson, DPT
• Jeffery Stopka
• Ellen A Stroud, LPC-MSHP

• Certified Registered Nurse Anesthetist in Jonesborough, TN
• Providers in Jonesborough, 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 Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.