Individual provider Active NPI

Bernie Folkerts, CRNA

  • Certified Registered Nurse Anesthetist
  • Clarksville, TN
National Provider Identifier
1548238488
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9808 Issued in TN
Practice address
651 Dunlop LN
Clarksville, TN 37040-5015
Phone
(931) 551-1795
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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 9808 TN Primary

Addresses

Primary practice location

651 Dunlop LN
Clarksville, TN 37040-5015

Mailing address

1817A Madison St
Ste 1
Clarksville, TN 37043-2930
Phone (931) 551-1795

Other identifiers 1

IdentifierTypeStateIssuer
3267864MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000866 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486740198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as apm
Quality
79.78
Promoting interoperability
93.11
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9808TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson County Eye Surgery Center, LLC Current Accepting new patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered CurrentSince May 31, 2014 Accepting new patients
Anesthesia Medical Group, PC CurrentSince May 31, 2014 Accepting new patients
Lebanon Hma Surgery Center Inc Past Accepting new patients

Locations

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

1670 W Main St
Ste 120
Lebanon, TN 37087
Phone (615) 453-4906

1411 W Baddour Pkwy
Lebanon, TN 37087
Phone (615) 443-2500

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

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1548238488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817A MADISON ST",
            "address_2": "STE 1",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432930",
            "telephone_number": "931-551-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 DUNLOP LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405015",
            "telephone_number": "931-551-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLKERTS",
        "first_name": "BERNIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "9808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3267864",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.