NPIMap

Individual provider Active NPI

Tammy Rothrock, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1477635696
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1084545 Issued in KY
Practice address
233 E Gray St
Suite 804
Louisville, KY 40202-2026
Phone
(502) 629-2880
NPI assigned
Oct 19, 2006
Last updated
Nov 17, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1084545 KY Primary

Addresses

Primary practice location

233 E Gray St
Suite 804
Louisville, KY 40202-2026

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (800) 394-4445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070301000306 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618079161 Reassigns benefits to 4 organizations
I20130204000136 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618079161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants Enterprises PLLCGroup PAC ID 9830268671, 124 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (859) 268-1030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1084545KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2017 Accepting new patients
Anesthesiology Consultants Enterprises, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 16, 2010 Accepting new patients
Providian Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 8, 2019 Accepting new patients
Lec Ancillary PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 13, 2017 Accepting new patients
Louisville Endoscopy Center, PLLC Past Accepting new patients

Locations

804 Scott Nixon Memorial Dr
Martinez, GA 30907

3423 Solutions Ctr
Chicago, IL 60677

7145 E Virginia St
Ste 1000
Evansville, IN 47715
Phone (812) 476-6166

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

1400 Poplar Level Rd
Ste 2
Louisville, KY 40217
Phone (502) 452-9567

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

9202 Leesgate Rd
Louisville, KY 40222
Phone (502) 276-5554

Organizations & group practices 5

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1477635696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "800-394-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E GRAY ST",
            "address_2": "SUITE 804",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022026",
            "telephone_number": "502-629-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHROCK",
        "first_name": "TAMMY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1084545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.