Individual provider Active NPI

Jonathan Lee Bennett

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1659504645
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN14335 Issued in TN
Practice address
2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239
Phone
(423) 698-3309
Fax
(423) 624-6355
NPI assigned
Aug 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN141413 TN
Certified Registered Nurse Anesthetist 367500000X APN14335 TN Primary

Addresses

Primary practice location

2341 McCallie Ave
Suite 402
Chattanooga, TN 37404-3239

Mailing address

PO Box 3549
Chattanooga, TN 37404-0549
Phone (423) 698-3309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160524000510 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294874228 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffee Medical Group LLCGroup PAC ID 1850208794, 22 clinicians

Practice addresses (Care Compare)

481 Interstate Dr
Manchester, TN 37355-3108
Phone (931) 728-6354

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14335TNMDAnesthesiology Physician
RN141413TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coffee Medical Group LLC CurrentSince Mar 1, 2023 Accepting new patients
Quiescence Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2022 Accepting new patients
Marvel Clinic P.C. CurrentSince May 11, 2022 Accepting new patients
Coffee Medical Group LLC CurrentSince Mar 1, 2023 Accepting new patients
Center for Day Surgery Current Accepting new patients
Webb Anesthesia Services, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2018 Accepting new patients
Cornerstone Anesthesia Group, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 26, 2016 Accepting new patients

Locations

315 Oak St
Livingston, TN 38570
Phone (931) 403-1197

481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

520 W Main St
Smithville, TN 37166
Phone (615) 215-5000

1821 N Washington St
Tullahoma, TN 37388
Phone (931) 455-2005

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1659504645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3549",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374040549",
            "telephone_number": "423-698-3309",
            "fax_number": "423-624-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 MCCALLIE AVE",
            "address_2": "SUITE 402",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043239",
            "telephone_number": "423-698-3309",
            "fax_number": "423-624-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JONATHAN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN141413",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN14335",
            "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 Sep 23, 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.