Individual provider Active NPI

Charles M Harvey, CRNA

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1497813463
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN8989 Issued in TN
Practice address
975 E. Third St
Chattanooga, TN 37403-2147
Phone
(423) 788-7608
Fax
(423) 778-2360
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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 RN47005 TN
Certified Registered Nurse Anesthetist 367500000X APN8989 TN Primary

Addresses

Primary practice location

975 E. Third St
Chattanooga, TN 37403-2147

Mailing address

PO Box 11225
Chattanooga, TN 37401-2225
Phone (423) 892-5602

Other identifiers 7

IdentifierTypeStateIssuer
000556718AMedicaidGA
430027336OtherTNRAILROAD MEDICARE
009709970MedicaidAL
3601730MedicaidTN
N369568OtherGAWELLCARE (GA MEDICAID)
3049766OtherTNBLUE CROSS BLUE SHIELD TN
8052357MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050623000891 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648215244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN47005TNMDRegistered Nurse
APN8989TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants Exchange, PC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 1990 Accepting new patients
Volunteer Anesthesia United, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Hamblen Anesthesia PC Nurse Anesthetist, Certified Registered PastSince Mar 13, 1995 Accepting new patients
Harbin Clinic, LLC Past Accepting new patients
The Baxley and Appling County Hospital Authority Past Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

979 E 3rd St
Ste C235
Chattanooga, TN 37403
Phone (423) 602-8400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1497813463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11225",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374012225",
            "telephone_number": "423-892-5602",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E. THIRD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-788-7608",
            "fax_number": "423-778-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN47005",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN8989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000556718A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430027336",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009709970",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3601730",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE (GA MEDICAID)",
            "identifier": "N369568",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "3049766",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052357",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.