Active NPI
Amanda Jernigan, CRNA
- Certified Registered Nurse Anesthetist
- Farmington, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CRNA-56272
- Practice address
- 801 W Maple St
Farmington, NM 87401-5630 - Phone
- (505) 609-2000
- Fax
- (505) 609-2259
- NPI assigned
- Jan 2, 2015
- 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 | APN0000019375 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | CRNA-56272 | NM | Primary |
Addresses
Primary practice location
801 W Maple St
Farmington, NM 87401-5630
Mailing address
PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258
Other practice location 1
Vanderbilt Medical Ctr
1211 Medical Center Drive
Nashville, TN 37232-0001
Phone (615) 322-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150422002377 | TN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 1850619875 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- American Anesthesiology of Tennessee PC
Practice addresses (Care Compare)
10820 Parkside Dr
Knoxville, TN 37934-1956
Phone (865) 546-8040
9300 Park W Blvd
Knoxville, TN 37923-4301
Phone (865) 546-8040
Hospital & facility affiliations
- Physicians Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRNA-56272 | NM | MD | Certified Registered Nurse Anesthetist |
| APN0000019375 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resource Anesthesia, P.C. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| American Anesthesiology of Tennessee, P.C. | Current | Accepting new patients | |
| Integrated Anesthesia Services, PLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Otolaryngology Head and Neck Surgery Associates | Current | Accepting new patients |
Locations
9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040
4713 Papermill Dr
Ste 100
Knoxville, TN 37909
Phone (865) 851-7771
9430 Park West Blvd
Ste 320
Knoxville, TN 37923
Phone (615) 441-4477
144 Concord Rd
Knoxville, TN 37934
550 Fort Loudon Medical Center Dr
#C
Lenoir City, TN 37772
345 23rd Ave N
Ste 209
Nashville, TN 37203
Phone (615) 329-5060
Organizations & group practices 4
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.
-
- Certified Registered Nurse Anesthetist
- Dickson, TN
- NPI 1194736108
Nurse Anesthetist, Certified Registered, TN
-
- Certified Registered Nurse Anesthetist
- Lenoir City, TN
- NPI 1033162045
Nurse Anesthetist, Certified Registered, TN
-
- Specialist
- Knoxville, TN
- NPI 1184704207
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": "1420156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1669860441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6210",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874996210",
"telephone_number": "505-609-2258",
"fax_number": "505-609-2259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 W MAPLE ST",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015630",
"telephone_number": "505-609-2000",
"fax_number": "505-609-2259"
}
],
"practiceLocations": [
{
"address_1": "Vanderbilt Medical Ctr",
"address_2": "1211 Medical Center Drive",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372320001",
"country_code": "US",
"telephone_number": "615-322-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JERNIGAN",
"first_name": "AMANDA",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-02",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "APN0000019375",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "CRNA-56272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.