Active NPI
Patrick Lee Herschelman, CRNA
- Certified Registered Nurse Anesthetist
- Maryville, TN
National Provider Identifier
1467498535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 10459
- Practice address
- 907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015 - Phone
- (865) 983-7211
- Fax
- (865) 983-8043
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 140556 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 0001229638 | VA | |
| Certified Registered Nurse Anesthetist | 367500000X | 10459 | TN | Primary |
Addresses
Primary practice location
907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Mailing address
PO Box 24776
Chattanooga, TN 37422
Phone (877) 288-1799
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100021714 | Other | TN | PHP TENNCARE |
| 127254 | Other | MO | BLUE CROSS |
| 3626241 | Medicaid | TN | |
| 4096641 | Other | TN | BLUE CROSS |
| P00201599 | Other | TN | MEDICARE TRAVELERS |
| 477005 | Other | MO | HEALTHLINK |
| 4096641 | Other | TN | BLUECARE |
| 915929715 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10459 | TN | MD | Physical Therapist |
| 140556 | MO | MD | Certified Registered Nurse Anesthetist |
| 0001229638 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Racine Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Laboratory Corportation of America Holdings | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Medical Laboratory
- Clinton, IN
- NPI 1194140293
-
- Anesthesiology Physician
- Mount Pleasant, WI
- NPI 1467782748
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448064000000",
"number": "1467498535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24776",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37422",
"telephone_number": "877-288-1799",
"fax_number": "423-892-5838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 E LAMAR ALEXANDER PKWY",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378045015",
"telephone_number": "865-983-7211",
"fax_number": "865-983-8043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSCHELMAN",
"first_name": "PATRICK",
"middle_name": "LEE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2015-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "140556",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0001229638",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "10459",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP TENNCARE",
"identifier": "100021714",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "127254",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3626241",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4096641",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE TRAVELERS",
"identifier": "P00201599",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "477005",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE",
"identifier": "4096641",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "915929715",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maryville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.