East Tennessee Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000109 Issued in TN

Legal business name

EAST TENNESSEE AMBULATORY SURGERY CENTER LLC

Practice address

701 Med Tech Pkwy
Johnson City, TN 37604-2259

Phone

(423) 283-7302

Fax

(423) 282-3670

NPI assigned

Oct 18, 2005

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jim N Brantner, MDNPI 1275522567

Title

Medical Director

Phone

(423) 283-7302

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Paragon Anesthesia PC

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1538174974

  O20090402000626

  Same enrollment

Listed as

East Tennessee Ambulatory Surgery CenterCCN 44C0001091

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Blue Ridge Medical Management Corporation

  dba DBA Heart & Vascular Group

  • Cardiovascular Disease Physician
  • Rogersville, TN
  • NPI 1194754234

  Member Of

  NPD member

Locations

Practitioners 283

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.

• Jim N Brantner, MD

  • Plastic Surgery Physician
  • Johnson City, TN
  • NPI 1275522567
  NPD (past) Authorized official
• David Q Andrews, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
  • NPI 1508847484
  NPD
• Leslie Michael Andrus, CRNA

  • Certified Registered Nurse Anesthetist
  • Hendersonville, TN
  • NPI 1396785788
  NPD
• Jeremy D Arnold, CRNA

  • Certified Registered Nurse Anesthetist
  • Bristol, TN
  • NPI 1396035853
  NPD
• David J Arrowood, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
  • NPI 1336444231
  NPD
• Brittany Arwood, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
  • NPI 1609537174
  NPD
• Ashton Asbury

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
  • NPI 1508564501
  NPD
• Joseph Barron Avery, MD

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1649765637
  NPD
• Saralee A Bailey, CRNA

  • Certified Registered Nurse Anesthetist
  • Bristol, TN
  • NPI 1043248404
  NPD
• Randy Lane Barton, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
  • NPI 1083653190
  NPD
• Laura Leigh Bassham, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
  • NPI 1710162789
  NPD
• Cynthia Ann Bayer, CRNA

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
  • NPI 1407818164
  NPD

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1659360071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042259",
            "telephone_number": "423-283-7302",
            "fax_number": "423-282-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042259",
            "telephone_number": "423-283-7302",
            "fax_number": "423-282-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BRANTNER",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "423-283-7302",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007447071",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3288092",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TENNCARE",
            "identifier": "3135707",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "3135707",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "145422",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ear Nose & Throat Associates PC
• Ear Nose and Throat Associates, P.C.
• Megan Elizabeth Earls, MS, RD
• Earth Remedy Optimal Wellness LLC (Soul Journey Bliss Center)
• John Tyler Earwood, PA
• East Tennessee Anesthesia Services, PLLC
• East Tennessee Anesthesia Services. LLC
• East Tennessee Brain & Spine Center, PC
• East Tennessee Family Care LLC
• East Tennessee Hearing Center

• Ambulatory Surgical Clinic/Center in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.