NPIMap

Organization Active NPI

Tennessee Valley Anesthesia PLLC

  • Anesthesiology Physician
  • Athens, TN
National Provider Identifier
1447202452
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TENNESSEE VALLEY ANESTHESIA PLLC
Practice address
105 N Meadows Dr
Athens, TN 37303-4172
Phone
(423) 649-3330
NPI assigned
May 17, 2006
Last updated
Jun 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Authorized official

Name
Mr. Michael J Fahey, CRNANPI 1669426029
Title
Chief Manager
Phone
(423) 618-3448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

105 N Meadows Dr
Athens, TN 37303-4172

Mailing address

5483 W Waters Ave Ste 1200
Tampa, FL 33634-1236
Phone (813) 287-5718

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050426000139 TN Part B Supplier - Clinic/Group Practice 1052350519 Receives reassigned benefits from 12 practitioners
Practice locations: Athens, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1447202452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5483 W WATERS AVE STE 1200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341236",
            "telephone_number": "813-287-5718",
            "fax_number": "813-287-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N MEADOWS DR",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373034172",
            "telephone_number": "423-649-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VALLEY ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "FAHEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "423-618-3448",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.