Individual provider Active NPI

Pete Michael Kimbley, RN

  • Certified Registered Nurse Anesthetist
  • Madison, TN
National Provider Identifier
1497427207
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
37933 Issued in TN
Practice address
315 Hospital Dr
Madison, TN 37115-5030
Phone
(615) 732-7671
NPI assigned
Sep 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 37933 TN Primary

Addresses

Primary practice location

315 Hospital Dr
Madison, TN 37115-5030

Mailing address

124 Grayson LN
White House, TN 37188-3001
Phone (615) 420-5435

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250306001101 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022539097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group, P.C.Group PAC ID 6901702307, 439 clinicians

Practice addresses (Care Compare)

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

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

3441 Dickerson Pike
Nashville, TN 37207-2539
Phone (615) 769-2000

355 New Shackle Island Rd
Hendersonville, TN 37075-2479
Phone (615) 338-1000

Hospital & facility affiliations

  • Tristar Hendersonville Medical Center Hospital, Hendersonville, TN, CCN 440194
  • Tristar Skyline Medical Center Hospital, Nashville, TN, CCN 440006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37933TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered CurrentSince Jan 30, 2025 Accepting new patients

Locations

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

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

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 and National Provider Directory roles.

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": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1497427207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GRAYSON LN",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371883001",
            "telephone_number": "615-420-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOSPITAL DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155030",
            "telephone_number": "615-732-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLEY",
        "first_name": "PETE",
        "middle_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-30",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "37933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.