Ida Pernell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

8954 Issued in TN

Practice address

1900 Exeter Rd
Suite 210
Germantown, TN 38138-2954

Phone

(901) 818-2160

Fax

(901) 682-9522

NPI assigned

May 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1447201348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 EXETER RD",
            "address_2": "SUITE 210",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382954",
            "telephone_number": "901-818-2160",
            "fax_number": "901-682-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 EXETER RD",
            "address_2": "SUITE 210",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382954",
            "telephone_number": "901-818-2160",
            "fax_number": "901-682-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNELL",
        "first_name": "IDA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "8954",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "044684",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3625361",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4011478",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430074179",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "98971",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126210",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick R Pelz, MD
• Joel Evan Perchik, M.D.
• David Perkins, CRNA
• Heather Perkins
• Sophia Perlich, PT, DPT
• Amanda Denise Person, APN
• Patrick R Person, D.D.S.
• Personalized Care LLC
• Tina Pham, PHARMD
• Pharmnp Enterprises LLC

• Certified Registered Nurse Anesthetist in Germantown, TN
• Providers in Germantown, 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 9, 2011; 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.