Active NPI
Tennessee Valley Anesthesia PLLC
- Anesthesiology Physician
- Athens, TN
National Provider Identifier
1447202452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael J Fahey, CRNA
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 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
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD2592 | Other | TN | RAILROAD MEDICARE GROUP |
| 3729421 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050426000139 | TN | Part B Supplier - Clinic/Group Practice | 1052350519 |
Receives reassigned benefits from 12 practitioners Practice locations: Athens, TN |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 13
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP",
"identifier": "DD2592",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3729421",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, TN
- Tennessee Cancer Specialists PLLC
- Tennessee CVS Pharmacy LLC
- Tennessee CVS Pharmacy LLC
- Tennessee Department of Health
- Tennessee Eye Care Specialists, PLLC
- Tennessee Valley Bone and Joint, LLC
- The Lactation Network, LLC
- The Surgery Center of Athens, LLC.
- Nichole Elaine Thomas
- Veliska Joy Thomas, LCSW
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.