Individual provider Active NPI

David Michael Underhill

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1467978338
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN23308 Issued in TN
Practice address
979 E 3Rd St Ste C235
Chattanooga, TN 37403-3309
Phone
(423) 602-8400
NPI assigned
Aug 22, 2017
Last updated
Jan 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 201167 TN
Certified Registered Nurse Anesthetist 367500000X APN23308 TN Primary

Addresses

Primary practice location

979 E 3Rd St Ste C235
Chattanooga, TN 37403-3309

Mailing address

16210 Crestview Dr
Sale Creek, TN 37373-7764
Phone (616) 890-2964

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214001776 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153689476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants Exchange, PCGroup PAC ID 2365434297, 152 clinicians

Practice addresses (Care Compare)

1751 Gunbarrel Rd
Chattanooga, TN 37421-7177
Phone (423) 602-8400

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 602-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
201167TNMDCritical Care Medicine Registered Nurse
APN23308TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants Exchange, PC Nurse Anesthetist, Certified Registered CurrentSince Oct 11, 2017 Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

979 E 3rd St
Ste C235
Chattanooga, TN 37403
Phone (423) 602-8400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1467978338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16210 CRESTVIEW DR",
            "city": "SALE CREEK",
            "state": "TN",
            "postal_code": "373737764",
            "telephone_number": "616-890-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE C235",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374033309",
            "telephone_number": "423-602-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERHILL",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TN",
            "license": "201167",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN23308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.