Individual provider Active NPI

James Witham Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Covington, TN
National Provider Identifier
1538260732
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN0000009553 Issued in TN
Practice address
1995 Highway 51 S
Covington, TN 38019-3635
Phone
(901) 475-4550
NPI assigned
Sep 26, 2006
Last updated
Sep 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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 APN0000009553 TN Primary

Addresses

Primary practice location

1995 Highway 51 S
Covington, TN 38019-3635

Mailing address

PO Box 1000 Dept 931
Memphis, TN 38148-0001
Phone (901) 382-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624000791 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294711032 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians

Practice addresses (Care Compare)

1995 Hwy 51 S
Covington, TN 38019-3635
Phone (901) 844-1590

2200 Union Ave
Memphis, TN 38104-4205
Phone (901) 274-5813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42955TNMDCardiovascular Disease Physician
APN0000009553TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA CurrentSince Sep 1, 2012 Accepting new patients
Lauderdale Community Hospital LLC CurrentSince Jan 1, 2021 Accepting new patients
Lauderdale Community Hospital LLC Current Accepting new patients
Gastroenterology Center of the Midsouth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 27, 2011 Accepting new patients
East Memphis Anesthesia Services PLC CurrentSince Jul 11, 2018 Accepting new patients
G I Diagnostic and Therapeutic Center LLC Current Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2019 Accepting new patients
Lauderdale Community Hospital LLC CurrentSince Jan 1, 2021 Accepting new patients
Cah Acquisition Company 11 LLC PastSince Mar 8, 2017 Accepting new patients

Locations

Gastro Onegovt Arhcl
New York, NY 10087

1995 Highway 51 S
Covington, TN 38019
Phone (901) 476-2621

1310 Wolf Park Dr
Germantown, TN 38138
Phone (901) 624-5151

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

700 W Forest Ave
Jackson, TN 38301
Phone (731) 424-8922

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

1325 Eastmoreland Ave
Ste 410
Memphis, TN 38104
Phone (901) 261-6650

2200 Union Ave
Memphis, TN 38104
Phone (901) 274-5813

255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804

326 Asbury Ave
Ripley, TN 38063
Phone (731) 221-2200

326 Asbury Ave
Ste 104
Ripley, TN 38063
Phone (731) 221-2200

340 Asbury Ave
Ripley, TN 38063
Phone (731) 221-2200

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/lauderd-6f671ec9

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1538260732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000 DEPT 931",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-382-1200",
            "fax_number": "901-382-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 HIGHWAY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193635",
            "telephone_number": "901-475-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHAM",
        "first_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000009553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.