Individual provider Active NPI

Samuel L Couillard, CRNA

  • Certified Registered Nurse Anesthetist
  • Lenoir City, TN
National Provider Identifier
1679560429
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN43073 Issued in TN
Practice address
550 Fort Loudoun Medical Center Dr
Lenoir City, TN 37772-5673
Phone
(952) 442-9770
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN43073 TN Primary

Addresses

Primary practice location

550 Fort Loudoun Medical Center Dr
Lenoir City, TN 37772-5673

Mailing address

233 W 1St St
Waconia, MN 55387-1302
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
4072021OtherTNBLUE CROSS OF TENNESSEE
3633144MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000432 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234121047 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN43073TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Novamed Surgery Center of Chattanooga, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 28, 2011 Accepting new patients
Novamed Surgery Center of Chattanooga LLC CurrentSince Oct 28, 2011 Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Chattanooga Anesthesia Services LLC Past Accepting new patients
Anesthesia Care Enterprises, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Chattanooga Anesthesia for Outpatient Surgery, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anes. Assc. of N. Alabama Past Accepting new patients
Surgical Services P.C. Past Accepting new patients
Woods Memorial Hospital Past Accepting new patients
Fort Loudoun Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Cleveland Anesthesiologists Inc PastSince Oct 8, 2012 Accepting new patients

Locations

7275 Reliable Pkwy
Chicago, IL 60686

867275 Reliable Pkwy
Chicago, IL 60686

1949 Gunbarrel Rd
Ste 200
Chattanooga, TN 37421
Phone (423) 855-5861

7305 Jarnigan Rd
Ste 200
Chattanooga, TN 37421
Phone (423) 855-6861

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679560429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 W 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871302",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FORT LOUDOUN MEDICAL CENTER DR",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725673",
            "telephone_number": "952-442-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUILLARD",
        "first_name": "SAMUEL",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN43073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TENNESSEE",
            "identifier": "4072021",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3633144",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.