Advanced Anesthsia LLC
Organization Active NPI Certified Registered Nurse Anesthetist · Memphis, TN
NPI 1487326310 · NPPES record last updated Sep 29, 2021
Key facts
- NPI
- 1487326310
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- Legal business name
- ADVANCED ANESTHSIA LLC
- Practice address
- 6133 Poplar Pike
Memphis, TN 38119-4707 - Phone
- (901) 753-8370
- NPI assigned
- Sep 29, 2021
- Organization subpart
- No
Authorized official
- Name
- Teddy T Winney Jr., CRNA
- Title
- Owner
- Phone
- (901) 647-1975
Practitioners 1
-
Teddy Winney Jr., CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211109002887 | TN | Part B Supplier - Clinic/Group Practice | 8628467834 |
Receives reassigned benefits from 1 practitioner Practice locations: Memphis, TN |
National Provider Directory
Locations
6133 Poplar Pike
Memphis, TN 38119
Phone (901) 737-8571
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist |
367500000X | Yes |
Addresses
Primary practice location
6133 Poplar Pike
Memphis, TN 38119-4707
Mailing address
P.O. Box 1000 Dept 339
Memphis, TN 38118
Phone (901) 753-8370
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053544916 | Other | TN | NPPES |
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All providers in Memphis, TN · Certified Registered Nurse Anesthetist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.