Individual provider Active NPI

Stephen Nichols

  • Certified Registered Nurse Anesthetist
  • Chattanooga, TN
National Provider Identifier
1700465689
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
137285 Issued in TN
Practice address
5307 Beulah Ave
Chattanooga, TN 37409-2145
Phone
(423) 314-0715
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 0000220246 TN
Certified Registered Nurse Anesthetist 367500000X 137285 TN Primary

Addresses

Primary practice location

5307 Beulah Ave
Chattanooga, TN 37409-2145

Mailing address

5307 Beulah Ave
Chattanooga, TN 37409-2145
Phone (423) 314-0715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211018003004 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587062872 Reassigns benefits to 2 organizations
I20251215003055 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587062872 Reassigns benefits to 1 organization

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
Memorial Health Partners Foundation IncGroup PAC ID 8022919570, 458 clinicians

Practice addresses (Care Compare)

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525

4710 Battlefield Pkwy
Ringgold, GA 30736-5164
Phone (423) 495-2525

Hospital & facility affiliations

  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000220246TNMDCritical Care Medicine Registered Nurse
137285TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation, Inc CurrentSince Jul 1, 2024 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Nov 16, 2021 Accepting new patients
Memorial Health Partners Foundation Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

611 E Villanow St
La Fayette, GA 30728
Phone (706) 638-1606

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

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

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

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.

Hospital & facility affiliations 2

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1700465689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 BEULAH AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374092145",
            "telephone_number": "423-314-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5307 BEULAH AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374092145",
            "telephone_number": "423-314-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "STEPHEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-11-03",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TN",
            "license": "0000220246",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "137285",
            "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 Nov 3, 2021; 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.