Active NPI
Mary Dana Traylor, CRNA
- Certified Registered Nurse Anesthetist
- Knoxville, TN
National Provider Identifier
1609838366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- APRN11007066
- Practice address
- 501 20TH St
Suite 606
Knoxville, TN 37916-1809 - Phone
- (865) 546-8040
- Fax
- (865) 541-2787
- NPI assigned
- Apr 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 11245 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | APRN11007066 | FL | Primary |
Addresses
Primary practice location
501 20TH St
Suite 606
Knoxville, TN 37916-1809
Mailing address
501 20TH St
Suite 606
Knoxville, TN 37916-1809
Phone (865) 546-8040
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4088461 | Other | TN | BLUECARE |
| P00175797 | Other | TN | TRAVELERS MEDICARE |
| 100042190 | Other | TN | PHP TENNCARE |
| 4088461 | Other | TN | BLUE CROSS |
| 3621826 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44249 | TN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670284800000",
"number": "1609838366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 20TH ST",
"address_2": "SUITE 606",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379161809",
"telephone_number": "865-546-8040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 20TH ST",
"address_2": "SUITE 606",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379161809",
"telephone_number": "865-546-8040",
"fax_number": "865-541-2787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAYLOR",
"first_name": "MARY",
"middle_name": "DANA",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-06",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "11245",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "APRN11007066",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE",
"identifier": "4088461",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS MEDICARE",
"identifier": "P00175797",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP TENNCARE",
"identifier": "100042190",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4088461",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3621826",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.