Individual provider Active NPI

Joshua O Leatherwood, CRNA

  • Certified Registered Nurse Anesthetist
  • Harrogate, TN
National Provider Identifier
1669089835
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
31351 Issued in TN
Practice address
6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245
Phone
(865) 309-0746
NPI assigned
Sep 30, 2020
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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 31351 TN Primary
Registered Nurse 163W00000X 219852 TN

Addresses

Primary practice location

6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245

Mailing address

6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220317001654 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648665240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Anesthesia Group PCGroup PAC ID 6901795830, 231 clinicians

Practice addresses (Care Compare)

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1000

990 Oak Ridge Tpke
Oak Ridge, TN 37830-6976
Phone (865) 835-3560

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219852TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Anesthesia Group, PC CurrentSince Jan 8, 2024 Accepting new patients

Locations

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

Dept 888089
Knoxville, TN 37995

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1669089835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6965 CUMBERLAND GAP PKWY",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "377528245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6965 CUMBERLAND GAP PKWY",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "377528245",
            "telephone_number": "865-309-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERWOOD",
        "first_name": "JOSHUA",
        "middle_name": "O",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-30",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "31351",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "219852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrogate, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.