Individual provider Active NPI

Nicole Siyem

  • Certified Registered Nurse Anesthetist
  • Nashville, TN
National Provider Identifier
1497421143
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN0000031474 Issued in TN
Practice address
1310 Havenbrook Dr
Nashville, TN 37207-2651
Phone
(240) 899-3479
NPI assigned
Aug 20, 2021
Last updated
Jun 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN0000031474 TN Primary
Registered Nurse 163W00000X 0000248999 TN

Addresses

Primary practice location

1310 Havenbrook Dr
Nashville, TN 37207-2651

Mailing address

3035 Sapgate LN
Nashville, TN 37207-3084
Phone (240) 899-3479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220502001657 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385031863 Reassigns benefits to 3 organizations
I20250605002032 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385031863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group, P.C.Group PAC ID 6901702307, 439 clinicians
TRH Anesthesia LLCGroup PAC ID 2062866395, 15 clinicians

Practice addresses (Care Compare)

110 29TH Ave N
Suite 202
Nashville, TN 37203-1448
Phone (615) 327-4304

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615
Phone (270) 465-3561

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.57 of 100Reported as group
Quality
59.49
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000248999TNMDRegistered Nurse
APN0000031474TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 9, 2024 Accepting new patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients
Knoxville Gastroenterology Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 8, 2024 Accepting new patients
TRH Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2025 Accepting new patients
T J Samson Community Hospital Nurse Anesthetist, Certified Registered CurrentSince May 9, 2025 Accepting new patients

Locations

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

310 N State of Franklin Rd
Ste 202
Johnson City, TN 37604
Phone (423) 434-3700

1311 Dowell Springs Blvd
Knoxville, TN 37909
Phone 86558851211644

110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870

629 Delozier Way
#100
Powell, TN 37849
Phone (865) 622-3442

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 2

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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1497421143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 SAPGATE LN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372073084",
            "telephone_number": "240-899-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HAVENBROOK DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072651",
            "telephone_number": "240-899-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIYEM",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2023-06-08",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000031474",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000248999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.