NPIMap

Organization Active NPI

Prime Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1649745225
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PRIME ANESTHESIA PLLC
Practice address
1304 McCallie Ave
Chattanooga, TN 37404-2933
Phone
(423) 622-7212
NPI assigned
Oct 10, 2018
Last updated
Aug 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bryan HurtNPI 1487617239
Title
Owner
Phone
(423) 503-9003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

1304 McCallie Ave
Chattanooga, TN 37404-2933

Mailing address

PO Box 2116
Collegedale, TN 37315-2116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190220000384 TN Part B Supplier - Clinic/Group Practice 3375881279 Receives reassigned benefits from 7 practitioners
Practice locations: Chattanooga, TN; Hixson, TN
O20190424002710 GA Part B Supplier - Clinic/Group Practice 3375881279 Receives reassigned benefits from 1 practitioner
Practice locations: Ringgold, GA

National Provider Directory

National Provider Directory

Locations

4700 Battlefield Pkwy
Ste 100
Ringgold, GA 30736
Phone (706) 806-0170

1304 McCallie Ave
Chattanooga, TN 37404
Phone (423) 622-7212

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1649745225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2116",
            "city": "COLLEGEDALE",
            "state": "TN",
            "postal_code": "373152116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042933",
            "telephone_number": "423-622-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "HURT",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-503-9003"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 25, 2020; 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.