Individual provider Active NPI

Enrique Molina, CRNA

  • Certified Registered Nurse Anesthetist
  • Pulaski, TN
National Provider Identifier
1497831291
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN9953 Issued in TN
Practice address
1265 E College St
Pulaski, TN 38478-4541
Phone
(615) 620-2320
Fax
(615) 620-2323
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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 APN9953 TN Primary
Registered Nurse 163W00000X RN102000 TN

Addresses

Primary practice location

1265 E College St
Pulaski, TN 38478-4541

Mailing address

PO Box 440401
Nashville, TN 37244-0401
Phone (615) 620-2320

Other identifiers 3

IdentifierTypeStateIssuer
4093506OtherTNBLUE CROSS/BLUE SHIELD OF TN
P00308720OtherTNRR MEDICARE
1515279MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090617000437 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062463722 Reassigns benefits to 3 organizations
I20101221000106 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062463722 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Nursing Anesthesia IncGroup PAC ID 9436459278, 43 clinicians

Practice addresses (Care Compare)

39700 Bob Hope Dr
Suite 204
Rancho Mirage, CA 92270-7109
Phone (615) 620-2320

500 W Votaw St
Portland, IN 47371-1322
Phone (260) 726-7131

Hospital & facility affiliations

  • Indiana University Health Jay, Inc. Hospital, Portland, IN, CCN 151320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN102000TNMDRegistered Nurse
APN9953TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Ball Memorial Physicians, Inc. CurrentSince Mar 1, 2018 Accepting new patients
Sda Services of Ca CurrentSince Jan 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 16, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Iu Health Medical Group, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2025 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Southern Tennessee Anesthesia Associates Nurse Anesthetist, Certified Registered Past Accepting new patients
Giles County Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients

Locations

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

3832 Solutions Ctr
Chicago, IL 60677

410 Pilgrim Blvd
Hartford City, IN 47348
Phone (317) 962-4272

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

1758 W 100 S
Portland, IN 47371
Phone (260) 726-1814

500 W Votaw St
Portland, IN 47371
Phone (260) 726-6515

400 10th St E
Waconia, MN 55387

Organizations & group practices 11

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1497831291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440401",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440401",
            "telephone_number": "615-620-2320",
            "fax_number": "615-620-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 E COLLEGE ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784541",
            "telephone_number": "615-620-2320",
            "fax_number": "615-620-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "ENRIQUE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN9953",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN102000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF TN",
            "identifier": "4093506",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00308720",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515279",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.