Individual provider Active NPI

Lisa Michelle Gammenthaler, CRNA

  • Certified Registered Nurse Anesthetist
  • Owensboro, KY
National Provider Identifier
1487029633
Registry record updated Dec 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3009942 Issued in KY
Practice address
1201 Pleasant Valley Rd
Owensboro, KY 42303-9811
Phone
(270) 417-2000
NPI assigned
Dec 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1146604 KY
Certified Registered Nurse Anesthetist 367500000X 3009942 KY Primary

Addresses

Primary practice location

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

Mailing address

6225 N State Highway 161
Ste# 200
Irving, TX 75038-2223
Phone (214) 687-0001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221104000461 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446530836 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradley Anesthesia Services PCGroup PAC ID 3274063425, 32 clinicians

Practice addresses (Care Compare)

2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone (423) 559-6000

Hospital & facility affiliations

  • Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1146604KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley Anesthesia Services PC CurrentSince Dec 4, 2024 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince May 19, 2024 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince May 19, 2024 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

10800 Parkside Dr
Ste 101
Knoxville, TN 37934
Phone (865) 218-7600

Organizations & group practices 3

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.

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": "1449964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449964800000",
    "number": "1487029633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161",
            "address_2": "STE# 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382223",
            "telephone_number": "214-687-0001",
            "fax_number": "972-518-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PLEASANT VALLEY RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039811",
            "telephone_number": "270-417-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMENTHALER",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-13",
        "last_updated": "2015-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1146604",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3009942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2015; 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.